Amino acid derived prodrugs of propofol, compositions and uses thereof

ABSTRACT

The present invention provides propofol prodrugs, methods of making propofol prodrugs, pharmaceutical compositions of propofol prodrugs and methods of using propofol prodrugs and pharmaceutical compositions thereof to treat or prevent diseases or disorders such as migraine headache pain and post-chemotherapy or post-operative surgery nausea and vomiting.

This application is a continuation application of U.S. patent application Ser. No. 11/180,064, now allowed, which claims the benefit under 35 U.S.C. § 119(e) from U.S. Provisional Application Ser. No. 60/587,611, filed Jul. 12, 2004, each of which is herein incorporated by reference in its entirety.

1. TECHNICAL FIELD

The present invention provides propofol prodrugs, methods of making propofol prodrugs, pharmaceutical compositions of propofol prodrugs and methods of using propofol prodrugs and pharmaceutical compositions thereof to treat or prevent diseases or disorders such as migraine headache pain and post-chemotherapy or post-operative surgery nausea and vomiting.

2. BACKGROUND ART

Propofol (2,6-diisopropylphenol), (1), is a low molecular weight phenol that is widely used as an intravenous sedative-hypnotic agent in the induction and maintenance of anesthesia and/or sedation in mammals. The advantages of propofol as an anesthetic include rapid onset of anesthesia, rapid clearance, and minimal side effects (Langley et al., Drugs 1988, 35, 334-372). Propofol may mediate hypnotic effects through interaction with the GABA_(A) receptor complex, a hetero-oligomeric ligand-gated chloride ion channel (Peduto et al., Anesthesiology 1991, 75, 1000-1009.).

Propofol is rapidly metabolized in mammals with the drug being eliminated predominantly as glucuronidated and sulfated conjugates of propofol and 4-hydroxypropofol (Langley et al., Drugs 1988, 35, 334-372). Propofol clearance exceeds liver blood flow, which indicates that extrahepatic tissues contribute to the overall metabolism of the drug. Human intestinal mucosa glucuronidates propofol in vitro and oral dosing studies in rats indicate that approximately 90% of the administered drug undergoes first pass metabolism, with extraction by the intestinal mucosa accounting for the bulk of this presystemic elimination (Raoof et al., Pharm. Res. 1996, 13, 891-895). Because of its extensive first-pass metabolism, propofol is administered by injection or intravenous infusion and oral administration has not been considered therapeutically effective.

Propofol has a broad range of biological and medical applications, which are evident at sub-anesthetic doses and include treatment and/or prevention of intractable migraine headache pain (Krusz et al., Headache 2000, 40, 224-230; Krusz, International Publication No. WO 00/54588). Propofol, when used to maintain anesthesia, causes a lower incidence of post-operative nausea and vomiting (“PONV”) when compared to common inhalation anesthetic agents and numerous controlled clinical studies support the anti-emetic activity of propofol (Tramer et al., Br. J. Anaesth. 1997, 78, 247-255; Brooker et al., Anaesth. Intensive Care 1998, 26, 625-629; Gan et al., Anesthesiology 1997, 87, 779-784). Propofol has also been shown to have anti-emetic activity when used in conjunction with chemotherapeutic compounds (Phelps et al., Ann. Pharmacother. 1996, 30, 290-292; Borgeat et al., Oncology 1993, 50, 456-459; Borgeat et al., Can. J Anaesth. 1994, 41, 1117-1119; Tomioka et al., Anesth. Analg. 1999, 89, 798-799). Nausea, retching and/or vomiting induced by a variety of chemotherapeutic agents (e.g., cisplatin, cyclophosphamide, 5-fluorouracil, methotrexate, anthracycline drugs, etc.) has been controlled by low-dose propofol infusion in patients refractory to prophylaxis with conventional anti-emetic drugs (e.g., serotonin antagonists and corticosteroids).

Propofol has also been used to treat patients with refractory status epilepticus (Brown et al., Pharmacother. 1998, 32, 1053-1059; Kuisma et al., Epilepsia 1995, 36, 1241-1243; Walder et al., Neurology 2002, 58, 1327-1332; Sutherland et al., Anaesth. Intensive Care 1994, 22, 733-737). Further, the anticonvulsant effects of propofol have also been demonstrated in rat efficacy models at sub-anesthetic doses (Holtkamp et al., Ann. Neurol. 2001, 49, 260-263; Hasan et al., Pharmacol. Toxicol. 1994, 74, 50-53).

Propofol has also been used as an antioxidant (Murphy et al., Br. J. Anaesth. 1992, 68, 613-618; Sagara et al., J. Neurochem. 1999, 73, 2524-2530; Young et al., Eur. J. Anaesthesiol. 1997, 14, 320-326; Wang et al. Eur. J. Pharmacol. 2002, 452, 303-308). Propofol, at doses typically used for surgical anesthesia, has observable antioxidant effects in humans (De la Cruz et al., Anesth. Analg. 1999, 89, 1050-1055). Pathogenesis or subsequent damage pathways in various neurodegenerative diseases involve reactive oxygen species and accordingly may be treated or prevented with antioxidants (Simonian et al., Pharmacol. Toxicol. 1996, 36, 83-106). Examples of specific neurodegenerative diseases which may be treated or prevented with anti-oxidants include, but are not limited to, Friedrich's disease, Parkinson's disease, Alzheimer's disease, Huntington's disease, amyotrophic lateral sclerosis (“ALS”), multiple sclerosis (“MS”), Pick disease, inflammatory diseases and diseases caused by inflammatory mediators such as tumor necrosis factor (TNF) and IL-1.

A significant problem with the formulation and use of propofol is poor water solubility. Accordingly, propofol must be specially formulated in aqueous media using solubilizers or emulsifiers (Briggs et al., Anaesthesia 1982, 37, 1099-1101). For example, in a current commercial product (Diprivan®, Astra-Zeneca) an oil-in-water emulsion (the emulsifier is the lecithin mixture Intralipid®), is used to formulate propofol (Picard et al., Anesth. Analg. 2000, 90, 963-969). Unfortunately, the oil-in-water emulsion formulation causes discomfort and pain at the site of injection.

One potential solution to the poor water solubility of propofol which avoids the use of additives, solubilizers or emulsifiers and the attendant injection site pain, is a water-soluble, stable propofol prodrug that is converted to propofol in vivo. (Hendler et al., International Publication No. WO 99/58555; Morimoto et al., International Publication No. WO 00/48572; Hendler et al., U.S. Pat. No. 6,254,853; Stella et al., United States Patent Application No. US2001/0025035; Hendler, U.S. Pat. No. 6,362,234; Hendler, International Publication No. WO 02/13810; Sagara et al., J. Neurochem. 1999, 73, 2524-2530; Banaszczyk et al., Anesth. Analg. 2002, 95, 1285-1292; Trapani et al., Int. J. Pharm. 1998, 175, 195-204; Trapani et al., J. Med. Chem. 1998, 41, 1846-1854; Anderson et al., J. Med. Chem. 2001, 44, 3582-3591; Pop et al., Med. Chem. Res. 1992, 2, 16-21). A significant problem with these existing propofol prodrugs is their high stability in vivo. This stability prevents release of therapeutically significant concentrations of propofol, particularly when the prodrug is orally administered.

Accordingly, there is a need for propofol prodrugs, which are sufficiently labile under physiological conditions to provide therapeutically effective concentrations of propofol, particularly, when the prodrug is orally administered.

3. SUMMARY

Disclosed herein are propofol prodrugs, methods of making propofol prodrugs, pharmaceutical compositions of propofol prodrugs and methods of using propofol prodrugs to treat or prevent diseases or disorders such as migraine headache pain, neurodegenerative disorders and post-chemotherapy or post-operative surgery nausea and vomiting which satisfies the above need. In one embodiment, prodrugs of propofol and pharmaceutical compositions thereof are orally administered. In another embodiment, prodrugs of propofol are translocated across the gastrointestinal mucosa via interaction with transporter proteins expressed within enterocytes lining the gastrointestinal tract.

In a first aspect, a compound of structural Formula (I) is provided:

or a pharmaceutically acceptable salt, hydrate, solvate or N-oxide thereof, wherein:

R¹ is selected from the group consisting of hydrogen, [R⁵NH(CHR⁴)_(p)C(O)]—, R⁶—, R⁶C(O)— and R⁶OC(O)—;

R² is —OR⁷ or —[NR⁸(CHR⁹)_(q)C(O)OR⁷];

p and q are independently 1 or 2;

each R⁴ is independently selected from the group consisting of hydrogen, alkyl, substituted alkyl, alkoxy, substituted alkoxy, acyl, substituted acyl, alkoxycarbonyl, substituted alkoxycarbonyl, aryl, substituted aryl, arylalkyl, substituted arylalkyl, carbamoyl, substituted carbamoyl, cycloalkyl, substituted cycloalkyl, cycloheteroalkyl, substituted cycloheteroalkyl, heteroalkyl, substituted heteroalkyl, heteroaryl, substituted heteroaryl, heteroarylalkyl and substituted heteroarylalkyl, or optionally, when R⁴ and R⁵ are attached to adjacent atoms then R⁴ and R⁵ together with the atoms to which they are bonded form a cycloheteroalkyl or substituted cycloheteroalkyl ring;

R⁵ is selected from the group consisting of hydrogen, R⁶—, R⁶C(O)— and R⁶OC(O)—;

R⁶ is selected from the group consisting of alkyl, substituted alkyl, aryl, substituted aryl, arylalkyl, substituted arylalkyl, cycloalkyl, substituted cycloalkyl, cycloheteroalkyl, heteroaryl, substituted heteroaryl and heteroarylalkyl;

R⁷ is selected from the group consisting of hydrogen, alkyl, substituted alkyl, aryl, substituted aryl, arylalkyl, substituted arylalkyl, cycloalkyl, substituted cycloalkyl, cycloheteroalkyl, heteroaryl, substituted heteroaryl and heteroarylalkyl;

R⁸ is selected from the group consisting of hydrogen, alkyl, substituted alkyl, aryl, substituted aryl, arylalkyl, cycloalkyl, substituted cycloalkyl, cycloheteroalkyl, heteroaryl, substituted heteroaryl and heteroarylalkyl;

each R⁹ is independently selected from the group consisting of hydrogen, alkyl, substituted alkyl, alkoxy, substituted alkoxy, acyl, substituted acyl, alkoxycarbonyl, substituted alkoxycarbonyl, aryl, substituted aryl, arylalkyl, substituted arylalkyl, carbamoyl, substituted carbamoyl, cycloalkyl, substituted cycloalkyl, cycloheteroalkyl, substituted cycloheteroalkyl, heteroalkyl, substituted heteroalkyl, heteroaryl, substituted heteroaryl, heteroarylalkyl and substituted heteroarylalkyl, or optionally, when R⁸ and R⁹ are attached to adjacent atoms then R⁸ and R⁹ together with the atoms to which they are bonded form a cycloheteroalkyl or substituted cycloheteroalkyl ring;

with the proviso that when R² is —[NR⁸(CHR⁹)_(q)C(O)OR⁷] then R¹ is not [R⁵NH(CHR⁴)_(p)C(O)]—.

In still another aspect, pharmaceutical compositions are provided. The pharmaceutical compositions disclosed herein generally comprise one or more compounds of Formulae (I)-(III) and a pharmaceutically acceptable vehicle such as a diluent, carrier, excipient or adjuvant. The choice of diluent, carrier, excipient and adjuvant will depend upon, among other factors, the desired mode of administration. In one embodiment, the mode of administration is oral.

In still another aspect, methods for treating various diseases or disorders are provided. The methods disclosed herein generally comprise administering one or more compounds of Formulae (I)-(III) in order to achieve a therapeutically effective concentration of propofol in the blood and/or tissue of a patient. The methods are useful for treating or preventing diseases or disorders including, but not limited to, migraine headache pain, post-chemotherapy or post-operative surgery nausea and vomiting and neurodegenerative disorders (e.g., epilepsy, Friedrich's disease, Parkinson's disease, Alzheimer's disease, Huntington's disease, amyotrophic lateral sclerosis (ALS), multiple sclerosis (MS), Pick disease, etc.). The methods generally involve administering to a patient in need of such treatment or prevention a therapeutically effective amount of one or more compounds of Formulae (I)-(III), or pharmaceutical composition containing one or more compounds of Formulae (I)-(III).

In still another aspect, methods for inducing and/or maintaining anesthesia or sedation in a mammal are provided. The methods generally involve administering to a patient in need of such anesthesia or sedation induction and/or maintenance a therapeutically effective amount of one or more compounds of Formulae (I)-(III), or pharmaceutical composition containing one or more compounds of Formulae (I)-(III).

4. DETAILED DESCRIPTION 4.1 Definitions

“Alkyl” by itself or as part of another substituent refers to a saturated or unsaturated, branched, straight-chain or cyclic monovalent hydrocarbon radical derived by the removal of one hydrogen atom from a single carbon atom of a parent alkane, alkene or alkyne. Typical alkyl groups include, but are not limited to, methyl; ethyls such as ethanyl, ethenyl, ethynyl; propyls such as propan-1-yl, propan-2-yl, cyclopropan-1-yl, prop-1-en-1-yl, prop-1-en-2-yl, prop-2-en-1-yl (allyl), cycloprop-1-en-1-yl; cycloprop-2-en-1-yl, prop-1-yn-1-yl, prop-2-yn-1-yl, etc.; butyls such as butan-1-yl, butan-2-yl, 2-methyl-propan-1-yl, 2-methyl-propan-2-yl, cyclobutan-1-yl, but-1-en-1-yl, but-1-en-2-yl, 2-methyl-prop-1-en-1-yl, but-2-en-1-yl, but-2-en-2-yl, buta-1,3-dien-1-yl, buta-1,3-dien-2-yl, cyclobut-1-en-1-yl, cyclobut-1-en-3-yl, cyclobuta-1,3-dien-1-yl, but-1-yn-1-yl, but-1-yn-3-yl, but-3-yn-1-yl, etc.; and the like.

The term “alkyl” is specifically intended to include groups having any degree or level of saturation, i.e., groups having exclusively single carbon-carbon bonds, groups having one or more double carbon-carbon bonds, groups having one or more triple carbon-carbon bonds and groups having mixtures of single, double and triple carbon-carbon bonds. Where a specific level of saturation is intended, the expressions “alkanyl,” “alkenyl,” and “alkynyl” are used. Preferably, an alkyl group comprises from 1 to 20 carbon atoms, more preferably, from 1 to 10 carbon atoms, even more preferably, 1 to 6 carbon atoms. “C₁₋₆ alkyl” refers to an alkyl group containing from 1 to 6 carbon atoms.

“Alkanyl” by itself or as part of another substituent refers to a saturated branched, straight-chain or cyclic alkyl radical derived by the removal of one hydrogen atom from a single carbon atom of a parent alkane. Typical alkanyl groups include, but are not limited to, methanyl; ethanyl; propanyls such as propan-1-yl, propan-2-yl (isopropyl), cyclopropan-1-yl, etc.; butanyls such as butan-1-yl, butan-2-yl (sec-butyl), 2-methyl-propan-1-yl (isobutyl), 2-methyl-propan-2-yl (t-butyl), cyclobutan-1-yl, etc.; and the like.

“Alkenyl” by itself or as part of another substituent refers to an unsaturated branched, straight-chain or cyclic alkyl radical having at least one carbon-carbon double bond derived by the removal of one hydrogen atom from a single carbon atom of a parent alkene. The group may be in either the cis or trans conformation about the double bond(s). Typical alkenyl groups include, but are not limited to, ethenyl; propenyls such as prop-1-en-1-yl, prop-1-en-2-yl, prop-2-en-1-yl (allyl), prop-2-en-2-yl, cycloprop-1-en-1-yl; cycloprop-2-en-1-yl; butenyls such as but-1-en-1-yl, but-1-en-2-yl, 2-methyl-prop-1-en-1-yl, but-2-en-1-yl, but-2-en-1-yl, but-2-en-2-yl, buta-1,3-dien-1-yl, buta-1,3-dien-2-yl, cyclobut-1-en-1-yl, cyclobut-1-en-3-yl, cyclobuta-1,3-dien-1-yl, etc.; and the like.

“Alkynyl” by itself or as part of another substituent refers to an unsaturated branched, straight-chain or cyclic alkyl radical having at least one carbon-carbon triple bond derived by the removal of one hydrogen atom from a single carbon atom of a parent alkyne. Typical alkynyl groups include, but are not limited to, ethynyl; propynyls such as prop-1-yn-1-yl, prop-2-yn-1-yl, etc.; butynyls such as but-1-yn-1-yl, but-1-yn-3-yl, but-3-yn-1-yl, etc.; and the like.

“Acyl” by itself or as part of another substituent refers to a radical —C(O)R³⁰, where R³⁰ is hydrogen, alkyl, cycloalkyl, cycloheteroalkyl, aryl, arylalkyl, heteroalkyl, heteroaryl, heteroarylalkyl as defined herein. Representative examples include, but are not limited to formyl, acetyl, cyclohexylcarbonyl, cyclohexylmethylcarbonyl, benzoyl, benzylcarbonyl and the like.

“Alkoxy” by itself or as part of another substituent refers to a radical —OR³¹ where R³¹ represents an alkyl or cycloalkyl group as defined herein. Representative examples include, but are not limited to, methoxy, ethoxy, propoxy, butoxy, cyclohexyloxy and the like.

“Alkoxycarbonyl” by itself or as part of another substituent, refers to a radical —C(O)OR³¹ where R³¹ is as defined above.

“Aryl” by itself or as part of another substituent refers to a monovalent aromatic hydrocarbon radical derived by the removal of one hydrogen atom from a single carbon atom of a parent aromatic ring system. Typical aryl groups include, but are not limited to, groups derived from aceanthrylene, acenaphthylene, acephenanthrylene, anthracene, azulene, benzene, chrysene, coronene, fluoranthene, fluorene, hexacene, hexaphene, hexylene, as-indacene, s-indacene, indane, indene, naphthalene, octacene, octaphene, octalene, ovalene, penta-2,4-diene, pentacene, pentalene, pentaphene, perylene, phenalene, phenanthrene, picene, pleiadene, pyrene, pyranthrene, rubicene, triphenylene, trinaphthalene and the like. Preferably, an aryl group comprises from 6 to 20 carbon atoms, more preferably, from 6 to 12 carbon atoms.

“Arylalkyl” by itself or as part of another substituent refers to an acyclic alkyl radical in which one of the hydrogen atoms bonded to a carbon atom, typically a terminal or sp³ carbon atom, is replaced with an aryl group. Typical arylalkyl groups include, but are not limited to, benzyl, 2-phenylethan-1-yl, 2-phenylethen-1-yl, naphthylmethyl, 2-naphthylethan-1-yl, 2-naphthylethen-1-yl, naphthobenzyl, 2-naphthophenylethan-1-yl and the like. Where specific alkyl moieties are intended, the nomenclature arylalkanyl, arylalkenyl and/or arylalkynyl is used. Preferably, an arylalkyl group is (C₆-C₃₀) arylalkyl, e.g., the alkanyl, alkenyl or alkynyl moiety of the arylalkyl group is (C₁-C₁₀) and the aryl moiety is (C₆-C₂₀), more preferably, an arylalkyl group is (C₆-C₂₀) arylalkyl, e.g., the alkanyl, alkenyl or alkynyl moiety of the arylalkyl group is (C₁-C₈) and the aryl moiety is (C₆-C₁₂).

“Carbamoyl” by itself or as part of another substituent refers to the radical —C(O)N(R³²)R³³ where R³² and R³³ are independently hydrogen, alkyl, substituted alkyl, aryl, substituted aryl, arylalkyl, substituted arylalkyl, heteroarylalkyl, substituted heteroarylalkyl, heteroaryl or substituted heteroaryl, as defined herein.

“Cycloalkyl” by itself or as part of another substituent refers to a saturated or unsaturated cyclic alkyl radical. Where a specific level of saturation is intended, the nomenclature “cycloalkanyl” or “cycloalkenyl” is used. Typical cycloalkyl groups include, but are not limited to, groups derived from cyclopropane, cyclobutane, cyclopentane, cyclohexane, and the like. Preferably, the cycloalkyl group is (C₃-C₁₀) cycloalkyl, more preferably, (C₃-C₇) cycloalkyl.

“Cycloheteroalkyl” by itself or as part of another substituent refers to a saturated or unsaturated cyclic alkyl radical in which one or more carbon atoms (and any associated hydrogen atoms) are independently replaced with the same or different heteroatom. Typical heteroatoms to replace the carbon atom(s) include, but are not limited to, N, P, O, S, Si, etc. Where a specific level of saturation is intended, the nomenclature “cycloheteroalkanyl” or “cycloheteroalkenyl” is used. Typical cycloheteroalkyl groups include, but are not limited to, groups derived from epoxides, azirines, thiiranes, imidazolidine, morpholine, piperazine, piperidine, pyrazolidine, pyrrolidino, quinuclidine and the like.

“Heteroalkyl Heteroalkanyl, Heteroalkenyl and Heteroalkynyl” by themselves or as part of another substituent refer to alkyl, alkanyl, alkenyl and alkynyl groups, respectively, in which one or more of the carbon atoms (and any associated hydrogen atoms) are independently replaced with the same or different heteroatomic groups. Typical heteroatomic groups which can be included in these groups include, but are not limited to, —O—, —S—, —O—O—, —S—S—, —O—S—, —NR³⁴R³⁵—, ═N—N═, —N═N—, —N═N—NR³⁶R³⁷, —PR³⁸—, —P(O)₂—, —POR³⁹—, —O—P(O)₂—, —SO—, —SO₂—, —SnR⁴⁰R⁴¹— and the like, where R³⁴, R³⁵, R³⁶, R³⁷, R³⁸, R³⁹, R⁴⁰ and R⁴¹ are independently hydrogen, alkyl, substituted alkyl, aryl, substituted aryl, arylalkyl, substituted arylalkyl, cycloalkyl, substituted cycloalkyl, cycloheteroalkyl, substituted cycloheteroalkyl, heteroalkyl, substituted heteroalkyl, heteroaryl, substituted heteroaryl, heteroarylalkyl or substituted heteroarylalkyl.

“Heteroaryl” by itself or as part of another substituent refers to a monovalent heteroaromatic radical derived by the removal of one hydrogen atom from a single atom of a parent heteroaromatic ring system. Typical heteroaryl groups include, but are not limited to, groups derived from acridine, arsindole, carbazole, β-carboline, chromane, chromene, cinnoline, furan, imidazole, indazole, indole, indoline, indolizine, isobenzofuran, isochromene, isoindole, isoindoline, isoquinoline, isothiazole, isoxazole, naphthyridine, oxadiazole, oxazole, perimidine, phenanthridine, phenanthroline, phenazine, phthalazine, pteridine, purine, pyran, pyrazine, pyrazole, pyridazine, pyridine, pyrimidine, pyrrole, pyrrolizine, quinazoline, quinoline, quinolizine, quinoxaline, tetrazole, thiadiazole, thiazole, thiophene, triazole, xanthene, and the like. Preferably, the heteroaryl group is from 5-20 membered heteroaryl, more preferably from 5-10 membered heteroaryl. Preferred heteroaryl groups are those derived from thiophene, pyrrole, benzothiophene, benzofuran, indole, pyridine, quinoline, imidazole, oxazole and pyrazine.

“Heteroarylalkyl” by itself or as part of another substituent refers to an acyclic alkyl radical in which one of the hydrogen atoms bonded to a carbon atom, typically a terminal or sp³ carbon atom, is replaced with a heteroaryl group. Where specific alkyl moieties are intended, the nomenclature heteroarylalkanyl, heteroarylalkenyl and/or heterorylalkynyl is used. In preferred embodiments, the heteroarylalkyl group is a 6-30 membered heteroarylalkyl, e.g., the alkanyl, alkenyl or alkynyl moiety of the heteroarylalkyl is 1-10 membered and the heteroaryl moiety is a 5-20-membered heteroaryl, more preferably, 6-20 membered heteroarylalkyl, e.g., the alkanyl, alkenyl or alkynyl moiety of the heteroarylalkyl is 1-8 membered and the heteroaryl moiety is a 5-12-membered heteroaryl.

“Parent Aromatic Ring System” refers to an unsaturated cyclic or polycyclic ring system having a conjugated π electron system. Specifically included within the definition of “parent aromatic ring system” are fused ring systems in which one or more of the rings are aromatic and one or more of the rings are saturated or unsaturated, such as, for example, fluorene, indane, indene, phenalene, etc. Typical aromatic ring systems include, but are not limited to, aceanthrylene, acenaphthylene, acephenanthrylene, anthracene, azulene, benzene, chrysene, coronene, fluoranthene, fluorene, hexacene, hexaphene, hexylene, as-indacene, s-indacene, indane, indene, naphthalene, octacene, octaphene, octalene, ovalene, penta-2,4-diene, pentacene, pentalene, pentaphene, perylene, phenalene, phenanthrene, picene, pleiadene, pyrene, pyranthrene, rubicene, triphenylene, trinaphthalene and the like.

“Parent Heteroaromatic Ring System” refers to an aromatic ring system in which one or more carbon atoms (and any associated hydrogen atoms) are independently replaced with the same or different heteroatom. Typical heteroatoms to replace the carbon atoms include, but are not limited to, N, P, O, S, Si, etc. Specifically included within the definition of “parent heteroaromatic ring systems” are fused ring systems in which one or more of the rings are aromatic and one or more of the rings are saturated or unsaturated, such as, for example, arsindole, benzodioxan, benzofuran, chromane, chromene, indole, indoline, xanthene, etc. Typical heteroaromatic ring systems include, but are not limited to, arsindole, carbazole, β-carboline, chromane, chromene, cinnoline, furan, imidazole, indazole, indole, indoline, indolizine, isobenzofuran, isochromene, isoindole, isoindoline, isoquinoline, isothiazole, isoxazole, naphthyridine, oxadiazole, oxazole, perimidine, phenanthridine, phenanthroline, phenazine, phthalazine, pteridine, purine, pyran, pyrazine, pyrazole, pyridazine, pyridine, pyrimidine, pyrrole, pyrrolizine, quinazoline, quinoline, quinolizine, quinoxaline, tetrazole, thiadiazole, thiazole, thiophene, triazole, xanthene, and the like.

“Pharmaceutically acceptable salt” refers to a salt of a compound of Formulae (I)-(III), which possesses the desired pharmacological activity of the parent compound. Such salts include: (1) acid addition salts, formed with inorganic acids such as hydrochloric acid, hydrobromic acid, sulfuric acid, nitric acid, phosphoric acid, and the like; or formed with organic acids such as acetic acid, propionic acid, hexanoic acid, cyclopentanepropionic acid, glycolic acid, pyruvic acid, lactic acid, malonic acid, succinic acid, malic acid, maleic acid, fumaric acid, tartaric acid, citric acid, benzoic acid, 3-(4-hydroxybenzoyl)benzoic acid, cinnamic acid, mandelic acid, methanesulfonic acid, ethanesulfonic acid, 1,2-ethane-disulfonic acid, 2-hydroxyethanesulfonic acid, benzenesulfonic acid, 4-chlorobenzenesulfonic acid, 2-naphthalenesulfonic acid, 4-toluenesulfonic acid, camphorsulfonic acid, 4-methylbicyclo[2.2.2]-oct-2-ene-1-carboxylic acid, glucoheptonic acid, 3-phenylpropionic acid, trimethylacetic acid, tertiary butylacetic acid, lauryl sulfuric acid, gluconic acid, glutamic acid, hydroxynaphthoic acid, salicylic acid, stearic acid, muconic acid, and the like; or (2) salts formed when an acidic proton present in the parent compound is replaced by a metal ion, e.g., an alkali metal ion, an alkaline earth ion, or an aluminum ion; or coordinates with an organic base such as ethanolamine, diethanolamine, triethanolamine, N-methylglucamine and the like.

“Pharmaceutically acceptable vehicle” refers to a diluent, adjuvant, excipient or carrier with which a compound of Formulae (I)-(III) is administered.

“Patient” includes humans. The terms “human” and “patient” are used interchangeably herein.

“PEPT1” refers to an oligopeptide transporter protein that normally absorbs dipeptides and tripeptides (and related structures) in certain tissues, such as the intestine (Adibi, S. A., Gastroenterology 1997, 113, 332-340; Leibach et al., Ann. Rev. Nutr. 1996, 16, 99-119).

“Preventing” or “prevention” refers to a reduction in risk of acquiring a disease or disorder (i.e., causing at least one of the clinical symptoms of the disease not to develop in a patient that may be exposed to or predisposed to the disease but does not yet experience or display symptoms of the disease).

“Prodrug” refers to a derivative of a drug molecule that requires a transformation within the body to release the active drug. Prodrugs are frequently, although not necessarily, pharmacologically inactive until converted to the parent drug. A hydroxyl containing drug may be converted to, for example, to an ester, carbonate, acyloxyalkyl or a sulfonate prodrug, which may be hydrolyzed in vivo to provide the hydroxyl compound. Prodrugs for drugs which functional groups different than those listed above are well known to the skilled artisan.

“Promoiety” refers to a form of protecting group that when used to mask a functional group within a drug molecule converts the drug into a prodrug. Typically, the promoiety will be attached to the drug via bond(s) that are cleaved by enzymatic or non-enzymatic means in vivo.

“Protecting group” refers to a grouping of atoms that when attached to a reactive functional group in a molecule masks, reduces or prevents reactivity of the functional group. Examples of protecting groups can be found in Green et al., “Protective Groups in Organic Chemistry”, (Wiley, 2^(nd) ed. 1991) and Harrison et al., “Compendium of Synthetic Organic Methods”, Vols. 1-8 (John Wiley and Sons, 1971-1996). Representative amino protecting groups include, but are not limited to, formyl, acetyl, trifluoroacetyl, benzyl, benzyloxycarbonyl (“CBz”), tert-butoxycarbonyl (“Boc”), trimethylsilyl (“TMS”), 2-trimethylsilyl-ethanesulfonyl (“SES”), trityl and substituted trityl groups, allyloxycarbonyl, 9-fluorenylmethyloxycarbonyl (“FMOC”), nitro-veratryloxycarbonyl (“NVOC”) and the like. Representative hydroxy protecting groups include, but are not limited to, those where the hydroxy group is either acylated or alkylated such as benzyl, and trityl ethers as well as alkyl ethers, tetrahydropyranyl ethers, trialkylsilyl ethers and allyl ethers.

“Substituted” refers to a group in which one or more hydrogen atoms are independently replaced with the same or different substituent(s). Typical substituents include, but are not limited to, -M, —R⁶⁰, —O—, ═O, —OR⁶⁰, —SR⁶⁰, —S⁻, ═S, —NR⁶⁰R⁶¹, ═NR⁶⁰, —CF₃, —CN, —OCN, —SCN, —NO, —NO₂, ═N₂, —N₃, —S(O)₂O⁻, —S(O)₂OH, —S(O)₂R⁶⁰, —OS(O₂)O⁻, —OS(O)₂R⁶⁰, —P(O)(O—)₂, —P(O)(OR⁶⁰)(O⁻), —OP(O)(OR⁶⁰)(OR⁶¹), —C(O)R⁶⁰, —C(S)R⁶⁰, —C(O)OR⁶⁰, —C(O)NR⁶⁰R⁶¹, —C(O)O⁻, —C(S)OR⁶⁰, —NR⁶²C(O)NR⁶⁰R⁶¹, —NR⁶²C(S)NR⁶⁰R⁶¹, —NR⁶²C(NR⁶³)NR⁶⁰R⁶¹ and —C(NR⁶²)NR⁶⁰R⁶¹ where M is independently a halogen; R⁶⁰, R⁶¹, R⁶² and R⁶³ are independently hydrogen, alkyl, substituted alkyl, alkoxy, substituted alkoxy, cycloalkyl, substituted cycloalkyl, cycloheteroalkyl, substituted cycloheteroalkyl, aryl, substituted aryl, heteroaryl or substituted heteroaryl, or optionally R⁶⁰ and R⁶¹ together with the nitrogen atom to which they are bonded form a cycloheteroalkyl or substituted cycloheteroalkyl ring; and R⁶⁴ and R⁶⁵ are independently hydrogen, alkyl, substituted alkyl, aryl, cycloalkyl, substituted cycloalkyl, cycloheteroalkyl, substituted cycloheteroalkyl, aryl, substituted aryl, heteroaryl or substituted heteroaryl, or optionally R⁶⁴ and R⁶⁵ together with the nitrogen atom to which they are bonded form a cycloheteroalkyl or substituted cycloheteroalkyl ring. Preferably, substituents include -M, —R⁶⁰, ═O, —OR⁶⁰, —SR⁶⁰, —S⁻, ═S, —NR⁶⁰R⁶¹, ═NR⁶⁰, —CF₃, —CN, —OCN, —SCN, —NO, —NO₂, ═N₂, —N₃, —S(O)₂R⁶⁰, —OS(O₂)O⁻, —OS(O)₂R⁶⁰, —P(O)(O⁻)₂, —P(O)(OR⁶⁰)(O⁻), —OP(O)(OR⁶⁰)(OR⁶¹), —C(O)R⁶⁰, —C(S)R⁶⁰, —C(O)OR⁶⁰, —C(O)NR⁶⁰R⁶¹, —C(O)O⁻, —NR⁶²C(O)NR⁶⁰R⁶¹, more preferably, -M, —R⁶⁰, ═O, —OR⁶⁰, —SR⁶⁰, —NR⁶⁰R⁶¹, —CF₃, —CN, —NO₂, —S(O)₂R⁶⁰, —P(O)(OR⁶⁰)(O⁻), —OP(O)(OR⁶⁰)(OR⁶¹), —C(O)R⁶⁰, —C(O)OR⁶⁰, —C(O)NR⁶⁰R⁶¹, —C(O)O⁻, most preferably, -M, —R⁶⁰, ═O, —OR⁶⁰, —SR⁶⁰, —NR⁶⁰R⁶¹, —CF₃, —CN, —NO₂, —S(O)₂R⁶⁰, —OP(O)(OR⁶⁰)(OR⁶¹), —C(O)R⁶⁰, —C(O)OR⁶⁰, —C(O)O⁻, where R⁶⁰, R⁶¹ and R⁶² are as defined above.

“Transported by the PEPT1 transporter” refers to the translocation of a molecule across a membrane of a cell expressing the PEPT1 transporter. The translocation occurs through interaction with the transporter and is energized by cotransport of H⁺ ions across the membrane.

“Treating” or “treatment” of any disease or disorder refers to one or more of the following: (1) ameliorating the disease or disorder (i.e., arresting or reducing the development of the disease or at least one of the clinical symptoms thereof); (2) ameliorating at least one physical parameter, which may not be discernible by the patient; (3) inhibiting the disease or disorder, either physically, (e.g., stabilization of a discernible symptom), physiologically, (e.g., stabilization of a physical parameter), or both; and (4) delaying the onset of the disease or disorder.

“Therapeutically effective amount” means the amount of a compound or composition that, when administered to a patient, is sufficient to effect the desired therapy. The “therapeutically effective amount” will vary depending on the compound, the disease and its severity and the age, weight, etc., of the patient to be treated.

Reference will now be made in detail to certain compounds and methods of making and administering these compounds. The invention is not limited to those compounds and methods but rather is defined by the claim(s) issuing herefrom.

4.2 Compounds

The compounds disclosed herein are prodrugs of propofol. A first class of propofol prodrugs including compounds of structural Formula (I) is provided:

or a pharmaceutically acceptable salt, hydrate, solvate or N-oxide thereof, wherein:

R¹ is selected from the group consisting of hydrogen, [R⁵NH(CHR⁴)_(p)C(O)]—, R⁶—, R⁶C(O)— and R⁶OC(O)—;

R² is —OR⁷ or —[NR⁸(CHR⁹)_(q)C(O)OR⁷];

p and q are independently 1 or 2;

each R⁴ is independently selected from the group consisting of hydrogen, alkyl, substituted alkyl, alkoxy, substituted alkoxy, acyl, substituted acyl, alkoxycarbonyl, substituted alkoxycarbonyl, aryl, substituted aryl, arylalkyl, substituted arylalkyl, carbamoyl, substituted carbamoyl, cycloalkyl, substituted cycloalkyl, cycloheteroalkyl, substituted cycloheteroalkyl, heteroalkyl, substituted heteroalkyl, heteroaryl, substituted heteroaryl, heteroarylalkyl and substituted heteroarylalkyl, or optionally, when R⁴ and R⁵ are attached to adjacent atoms then R⁴ and R⁵ together with the atoms to which they are bonded form a cycloheteroalkyl or substituted cycloheteroalkyl ring;

R⁵ is selected from the group consisting of hydrogen, R⁶—, R⁶C(O)— and R⁶OC(O)—;

R⁶ is selected from the group consisting of alkyl, substituted alkyl, aryl, substituted aryl, arylalkyl, substituted arylalkyl, cycloalkyl, substituted cycloalkyl, cycloheteroalkyl, heteroaryl, substituted heteroaryl and heteroarylalkyl;

R⁷ is selected from the group consisting of hydrogen, alkyl, substituted alkyl, aryl, substituted aryl, arylalkyl, substituted arylalkyl, cycloalkyl, substituted cycloalkyl, cycloheteroalkyl, heteroaryl, substituted heteroaryl and heteroarylalkyl;

R⁸ is selected from the group consisting of hydrogen, alkyl, substituted alkyl, aryl, substituted aryl, arylalkyl, cycloalkyl, substituted cycloalkyl, cycloheteroalkyl, heteroaryl, substituted heteroaryl and heteroarylalkyl;

each R⁹ is independently selected from the group consisting of hydrogen, alkyl, substituted alkyl, alkoxy, substituted alkoxy, acyl, substituted acyl, alkoxycarbonyl, substituted alkoxycarbonyl, aryl, substituted aryl, arylalkyl, substituted arylalkyl, carbamoyl, substituted carbamoyl, cycloalkyl, substituted cycloalkyl, cycloheteroalkyl, substituted cycloheteroalkyl, heteroalkyl, substituted heteroalkyl, heteroaryl, substituted heteroaryl, heteroarylalkyl and substituted heteroarylalkyl, or optionally, when R⁸ and R⁹ are attached to adjacent atoms then R⁸ and R⁹ together with the atoms to which they are bonded form a cycloheteroalkyl or substituted cycloheteroalkyl ring;

with the proviso that when R² is —[NR⁸(CHR⁹)_(q)C(O)OR⁷] then R¹ is not [R⁵NH(CHR⁴)_(p)C(O)]—.

In some embodiments, a compound of Formula (I) is derived from α-amino acids (e.g., [H₂N(CHR⁴)C(O)OH] and/or [HNR⁸(CHR⁹)C(O)OH]) including, but not limited to, the 20 genetically encoded amino acids and the non-coded amino acids such as, for example, 2,3-diaminobutyric acid, 2,4-diaminobutyric acid, hydroxylysine, homoserine, homoarginine, homotyrosine, homocysteine, homophenylalanine, citrulline, sarcosine, orthinine, N-methylleucine, kynurenine, penicillamine, 4-aminophenylalanine, 3-(2-naphthyl)alanine, 3-(1-naphthyl)alanine, methionine sulfone, methionine sulfoxide, t-butylalanine, 4-hydroxyphenylglycine, aminoalanine, 1,2,3,4 tetrahydrorisoquinoline-3-carboxylic acid, vinylalanine, propargylglycine, 1,2,4-triazolo-3-alanine, 4,4,4-trifluoro-threonine, thyronine, 6-hydroxytryptophan, 5-hydroxytryptophan, 3-hydroxykynurenine, 3-aminotyrosine, trifluoromethylalanine (2-(4-pyridyl)ethyl)cysteine, 3,4-dimethoxy-phenylalanine, 3-(2-thiazolyl)alanine, ibotenic acid, quisqualic acid, 3-trifluoromethylphenylalanine, 4-trifluoromethylphenylalanine, t-butylglycine, cyclopentylglycine, cyclohexylglycine, phenylglycine, cyclohexylalanine, thiohistidine, 3-methoxytyrosine, norleucine, norvaline, alloisoleucine, thioproline, dehydroproline, hydroxyproline, isonipectotic acid, homoproline, N-acetyl lysine, aminophenylbutyric acid, phenylalanines substituted at the ortho, meta or para position of the phenyl moiety with one or two of the following: a (C₁-C₄) alkyl, a (C₁-C₄) alkoxy, halogen or nitro groups or substituted with a methylenedioxy group, β-2- and 3-thienylalanine, β-2- and 3-furanylalanine, 2-, 3- and 4-pyridylalanine, β-(benzothienyl-2- and 3-yl)alanine, β-(1- and 2-naphthyl)alanine, O-sulfate, O-phosphate and O-carboxylate esters of tyrosine, 3-sulfo-tyrosine, 3-carboxy-tyrosine, 3-phospho-tyrosine, 4-methane sulfonic acid ester of tyrosine, 4-methane phosphonic acid ester of tyrosine, 3,5-diiodotyrosine or 3-nitrotyrosine.

In other embodiments of a compound of Formula (I), R¹ is hydrogen or [R⁵NH(CHR⁴)_(p)C(O)]—, where p is 1. Preferably, R⁴ is hydrogen, alkanyl, substituted alkanyl, aryl, substituted aryl, arylalkanyl, substituted arylalkanyl, cycloalkanyl, heteroarylalkanyl or substituted heteroarylalkanyl, or optionally, R⁴ and R⁵ together with the atoms to which they are bonded form a cycloheteroalkyl or substituted cycloheteroalkyl ring.

In still other embodiments of a compound of Formula (I), R¹ is [R⁵NH(CHR⁴)_(p)C(O)]—, p is 1, R⁵ is hydrogen and R⁴ is hydrogen, alkanyl or cycloalkanyl. Preferably, R⁴ is hydrogen, methyl, isopropyl, isobutyl, sec-butyl, t-butyl, cyclopentyl or cyclohexyl.

In still other embodiments of a compound of Formula (I), R¹ is [R⁵NH(CHR⁴)_(p)C(O)]—, p is 1, R⁵ is hydrogen, and R⁴ is substituted alkanyl. Preferably, R⁴ is —CH₂OH, —CH(OH)CH₃, —CH₂CO₂H, —CH₂CH₂CO₂H, —CH₂CONH₂, —CH₂CH₂CONH₂, —CH₂CH₂SCH₃, —CH₂SH, —CH₂(CH₂)₃NH₂ or —CH₂CH₂CH₂NHC(NH)NH₂.

In still other embodiments of a compound of Formula (I), R¹ is [R⁵NH(CHR⁴)_(p)C(O)]—, p is 1, R⁵ is hydrogen, and R⁴ is aryl, arylalkanyl, substituted arylalkanyl or heteroarylalkanyl. Preferably, R⁴ is phenyl, benzyl, 4-hydroxybenzyl, 4-imidazolylmethyl or 3-indolylmethyl

In still other embodiments of a compound of Formula (I), R¹ is [R⁵NH(CHR⁴)_(p)C(O)]—, p is 1 and R⁴ and R⁵ together with the atoms to which they are bonded form a cycloheteroalkyl or substituted cycloheteroalkyl ring. Preferably R⁴ and R⁵ together with the atoms to which they are bonded form an azetidine, pyrrolidine or piperidine ring.

In still other embodiments of a compound of Formula (I), R¹ is [R⁵NH(CHR⁴)_(p)C(O)]—, p is 1, R⁴ is hydrogen, alkanyl, substituted alkanyl, aryl, substituted aryl, arylalkanyl, substituted arylalkanyl, cycloalkanyl, heteroarylalkanyl or substituted heteroarylalkanyl, R⁵ is R⁶—, R⁶C(O)— or R⁶OC(O)— and R⁶ is alkyl, substituted alkyl, aryl, substituted aryl, arylalkyl, substituted arylalkyl, cycloalkyl, substituted cycloalkyl, cycloheteroalkyl, heteroaryl, substituted heteroaryl or heteroarylalkyl. Preferably, R⁶ is C₁₋₄ alkyl, phenyl, substituted phenyl, benzyl or substituted benzyl.

In still other embodiments of a compound of Formula (I), R¹ is hydrogen or [R⁵NH(CHR⁴)_(p)C(O)]—, where p is 2. Preferably, R⁴ is hydrogen, alkanyl, substituted alkanyl, aryl, substituted aryl, arylalkanyl, substituted arylalkanyl, cycloalkanyl, heteroarylalkanyl or substituted heteroarylalkanyl, or optionally, when R⁴ and R⁵ are attached to adjacent atoms then R⁴ and R⁵ together with the atoms to which they are bonded form a cycloheteroalkyl or substituted cycloheteroalkyl ring.

In still other embodiments of a compound of Formula (I), R¹ is [R⁵NH(CHR⁴)_(p)C(O)]—, p is 2 and R⁴ is hydrogen, alkanyl, substituted alkanyl, aryl, substituted aryl, arylalkanyl, substituted arylalkanyl, cycloalkanyl, heteroarylalkanyl or substituted heteroarylalkanyl. Preferably, R⁴ is hydrogen, C₁₋₄ alkyl, cyclopentyl, cyclohexyl, phenyl, substituted phenyl, benzyl or substituted benzyl.

In still other embodiments of a compound of Formula (I), R¹ is [R⁵NH(CHR⁴)_(p)C(O)]—, p is 2, R⁵ is hydrogen and R⁴ is hydrogen, C₁₋₄ alkyl, cyclopentyl, cyclohexyl, phenyl, substituted phenyl, benzyl or substituted benzyl.

In still other embodiments of a compound of Formula (I), R² is —OR⁷ and R⁷ is hydrogen, alkyl, aryl, substituted aryl, arylalkyl or substituted arylalkyl. Preferably, R⁷ is hydrogen, C₁₋₄ alkyl, phenyl, substituted phenyl, benzyl or substituted benzyl.

In still other embodiments of a compound of Formula (I), R² is —[NR⁸(CHR⁹)_(q)C(O)OR⁷], q is 1, R⁷ is hydrogen, alkyl, aryl, substituted aryl, arylalkyl or substituted arylalkyl. Preferably, R⁷ is hydrogen, C₁₋₄ alkyl, phenyl, substituted phenyl, benzyl or substituted benzyl.

In still other embodiments of a compound of Formula (I), R² is [NR⁸(CHR⁹)_(q)C(O)OR⁷], q is 1, R⁸ is hydrogen and R⁹ is hydrogen, alkanyl, substituted alkanyl, aryl, substituted aryl, arylalkanyl, substituted arylalkanyl, cycloalkanyl, heteroarylalkanyl or substituted heteroarylalkanyl. Preferably, R⁷ hydrogen, alkyl, aryl, substituted aryl, arylalkyl or substituted arylalkyl, more preferably, R⁷ is hydrogen, C₁₋₄ alkyl, phenyl, substituted phenyl, benzyl or substituted benzyl.

In still other embodiments of a compound of Formula (I), R² is —[NR⁸(CHR⁹)_(q)C(O)OR⁷], q is 1, R⁷ is hydrogen, alkyl, aryl, substituted aryl, arylalkyl or substituted arylalkyl, R⁸ is hydrogen and R⁹ is hydrogen, alkanyl or cycloalkanyl. Preferably, R⁹ is hydrogen, methyl, isopropyl, isobutyl, sec-butyl, t-butyl, cyclopentyl or cyclohexyl. Preferably, R⁷ is hydrogen, C₁₋₄ alkyl, phenyl, substituted phenyl, benzyl or substituted benzyl.

In still other embodiments of a compound of Formula (I), R² is —[NR⁸(CHR⁹)_(q)C(O)OR⁷], q is 1, R⁷ is hydrogen, alkyl, aryl, substituted aryl, arylalkyl or substituted arylalkyl, R⁸ is hydrogen and R⁹ is substituted alkanyl. Preferably, R⁹ is —CH₂OH, —CH(OH)CH₃, —CH₂CO₂H, —CH₂CH₂CO₂H, —CH₂CONH₂, —CH₂CH₂CONH₂, —CH₂CH₂SCH₃, —CH₂SH, —CH₂(CH₂)₃NH₂ or —CH₂CH₂CH₂NHC(NH)NH₂. Preferably, R⁷ is hydrogen, C₁₋₄ alkyl, phenyl, substituted phenyl, benzyl or substituted benzyl.

In still other embodiments of a compound of Formula (I), R² is —[NR⁸(CHR⁹)_(q)C(O)OR⁷], q is 1, R⁷ is hydrogen, alkyl, aryl, substituted aryl, arylalkyl or substituted arylalkyl, R⁸ is hydrogen and R⁹ is aryl, arylalkanyl, substituted arylalkanyl or heteroarylalkanyl. Preferably, R⁹ is phenyl, benzyl, 4-hydroxybenzyl, 4-imidazolylmethyl or 3-indolylmethyl. Preferably R⁷ is hydrogen, C₁₋₄ alkyl, phenyl, substituted phenyl, benzyl or substituted benzyl.

In still other embodiments of a compound of Formula (I), R² is —[NR⁸(CHR⁹)_(q)C(O)OR⁷], q is 1, R⁷ is hydrogen, alkyl, aryl, substituted aryl, arylalkyl or substituted arylalkyl and R⁸ and R⁹ together with the atoms to which they are bonded form a cycloheteroalkyl or substituted cycloheteroalkyl ring. Preferably R⁸ and R⁹ together with the atoms to which they are bonded form an azetidine, pyrrolidine or piperidine ring. Preferably, R⁷ is hydrogen, C₁₋₄ alkyl, phenyl, substituted phenyl, benzyl or substituted benzyl.

In still other embodiments of a compound of Formula (I), R² is —[NR⁸(CHR⁹)_(q)C(O)OR⁷], q is 2, R⁷ is hydrogen, alkyl, aryl, substituted aryl, arylalkyl or substituted arylalkyl and R⁹ is hydrogen, alkanyl, substituted alkanyl, aryl, substituted aryl, arylalkanyl, substituted arylalkanyl, cycloalkanyl, heteroarylalkanyl or substituted heteroarylalkanyl. Preferably, R⁷ is hydrogen, C₁₋₄ alkyl, phenyl, substituted phenyl, benzyl or substituted benzyl. Preferably, R⁸ is hydrogen and R⁹ is hydrogen, C₁₋₄ alkyl, cyclopentyl, cyclohexyl, phenyl, substituted phenyl, benzyl or substituted benzyl.

In still other embodiments of a compound of Formula (I), R¹ is [R⁵NH(CHR⁴)_(p)C(O)]—, p is 1, R⁵ is hydrogen and R² is —OH to provide a compound of Formula (II):

or a pharmaceutically acceptable salt, hydrate, solvate or N-oxide thereof, wherein R⁴ is hydrogen, alkanyl, substituted alkanyl, aryl, substituted aryl, arylalkanyl, substituted arylalkanyl, cycloalkanyl, heteroarylalkanyl or substituted heteroarylalkanyl.

In some embodiments of a compound of Formula (II), R⁴ is hydrogen, alkanyl or cycloalkanyl. Preferably, R⁴ is hydrogen, methyl, isopropyl, isobutyl, sec-butyl, t-butyl, cyclopentyl or cyclohexyl.

In other embodiments of a compound of Formula (II), R⁴ is substituted alkanyl. Preferably, R⁴ is —CH₂OH, —CH(OH)CH₃, —CH₂CO₂H, —CH₂CH₂CO₂H, —CH₂CONH₂, —CH₂CH₂CONH₂, —CH₂CH₂SCH₃, —CH₂SH, —CH₂(CH₂)₃NH₂ or —CH₂CH₂CH₂NHC(NH)NH₂.

In still other embodiments of a compound of Formula (II), R⁴ is aryl, arylalkanyl, substituted arylalkanyl or heteroarylalkanyl. Preferably, R⁴ is phenyl, benzyl, 4-hydroxybenzyl, 4-imidazolylmethyl or 3-indolylmethyl.

In still other embodiments of a compound of Formula (II), the α-carbon of the N-terminal amino acid residue is of the L-configuration. In still other embodiments of a compound of Formula (II), the α-carbon of the N-terminal amino acid residue is of the D-configuration. In still other embodiments of a compound of Formula (II), the α-carbon of the C-terminal amino acid residue is of the L-configuration. In still other embodiments of a compound of Formula (II), the α-carbon of the C-terminal amino acid residue is of the D-configuration. In still other embodiments of a compound of Formula (II), the α-carbons of both the N- and C-terminal amino acid residues are of the L-configuration.

In still other embodiments of a compound of Formula (I), R¹ is hydrogen and R² is —OH to provide a compound of Formula (III):

or a pharmaceutically acceptable salt, hydrate or solvate thereof.

In some embodiment of a compound of Formula (III), the α-carbon of the amino acid residue is of the L-configuration. In other embodiments of a compound of Formula (III), the α-carbon of the amino acid residue is of the D-configuration.

Compounds disclosed herein may be identified either by their chemical structure and/or chemical name. When the chemical structure and chemical name conflict, the chemical structure is determinative of the identity of the compound.

Compounds described herein may contain one or more chiral centers and/or double bonds and therefore, may exist as stereoisomers, such as double-bond isomers (i.e., geometric isomers), enantiomers or diastereomers. Accordingly, when stereochemistry at chiral centers is not specified, the chemical structures depicted herein encompass all possible configurations at those chiral centers including the stereoisomerically pure form (e.g., geometrically pure, enantiomerically pure or diastereomerically pure) and enantiomeric and stereoisomeric mixtures. Enantiomeric and stereoisomeric mixtures can be resolved into their component enantiomers or stereoisomers using separation techniques or chiral synthesis techniques well known to the skilled artisan. Compounds disclosed herein may also exist in several tautomeric forms including the enol form, the keto form and mixtures thereof. Accordingly, the chemical structures depicted herein encompass all possible tautomeric forms of the illustrated compounds.

Compounds disclosed herein also include isotopically labeled compounds where one or more atoms have an atomic mass different from the atomic mass conventionally found in nature. Examples of isotopes that may be incorporated into the compounds include, but are not limited to, ²H, ³H, ¹¹C, ¹³C, ¹⁴C, ¹⁵N, ¹⁷O and ¹⁸O.

Compounds disclosed herein may exist in unsolvated forms as well as solvated forms, including hydrated forms and as N-oxides. In general, the hydrated, solvated and N-oxide forms are within the scope of the present invention. Certain compounds may exist in multiple crystalline or amorphous forms. In general, all physical forms are equivalent for the uses contemplated herein and are intended to be within the scope of the present disclosure. Further, it should be understood, when partial structures of the compounds are illustrated, that brackets indicate the point of attachment of the partial structure to the rest of the molecule.

Compounds of structural Formulae (I)-(III) may be administered orally and transported across cells (i.e., enterocytes) lining the lumen of the gastrointestinal tract. While not wishing to be bound by any particular transport mechanism, some of the compounds of structural Formulae (I)-(III) may be substrates for the proton-coupled intestinal peptide transport system (“PEPT1”) (Leibach et al., Annu. Rev. Nutr. 1996, 16, 99-119) which, typically mediates the cellular uptake of small intact peptides consisting of two or three amino acids that are derived from the digestion of dietary proteins. In the intestine, where small peptides are not effectively absorbed by passive diffusion, PEPT1 may act as a vehicle for their effective uptake across the apical membrane of the gastric mucosa.

Methods for determining whether compounds of Formulae (I)-(III) serve as substrates for the PEPT1 transporter are disclosed in Example 23 herein (see Section 5). In vitro systems, which use cells engineered to heterologously express the transport system, or cell-lines that endogenously express the transporter (e.g. Caco-2 cells) may be used to assay transport of compounds of Formulae (I)-(III) by PEPT1 transporter. Standard methods for evaluating the enzymatic conversion of propofol prodrug compounds to propofol in vitro are disclosed in Example 24 herein.

Oral administration of propofol prodrug compounds to monkeys is described in Example 25, and illustrates that actively transported prodrugs can afford significant enhancements in oral bioavailability of propofol.

4.3 Synthesis of Propofol Prodrug Compounds

The compounds of Formulae (I)-(III) may be obtained via the synthetic methods illustrated in Schemes 1-3. Starting materials useful for preparing these compounds and intermediates thereof are commercially available or can be prepared by well-known synthetic methods (Harrison et al., “Compendium of Synthetic Organic Methods”, Vols. 1-8 (John Wiley and Sons, 1971-1996); “Beilstein Handbook of Organic Chemistry,” Beilstein Institute of Organic Chemistry, Frankfurt, Germany; Feiser et al., “Reagents for Organic Synthesis,” Volumes 1-17, Wiley Interscience; Trost et al., “Comprehensive Organic Synthesis,” Pergamon Press, 1991; “Theilheimer's Synthetic Methods of Organic Chemistry,” Volumes 1-45, Karger, 1991; March, “Advanced Organic Chemistry,” Wiley Interscience, 1991; Larock “Comprehensive Organic Transformations,” VCH Publishers, 1989; Paquette, “Encyclopedia of Reagents for Organic Synthesis,” John Wiley & Sons, 1995). Other methods for synthesis of the compounds described herein and/or starting materials are either described in the art or will be readily apparent to the skilled artisan. Accordingly, the methods presented in Schemes 1-2 herein are illustrative rather than comprehensive.

Amino acid building blocks useful for the preparation of compounds of Formulae (I)-(III) typically incorporate one or more protecting groups. Non-limiting examples of useful protecting groups for the nitrogen atom of such amino acids include tert-butyloxycarbonyl (Boc), benzyloxycarbonyl (CBz) and 9-fluorenylmethyloxycarbonyl (Fmoc) moieties, while those for the carboxyl group include tert-butyl, benzyl and 9-fluorenylmethyl esters. Amino acids of either L- or D-stereochemistry may be used in these reactions. The threonine moiety in compounds of Formula (I)-(III) may be derived from L-threonine, D-threonine, or the epimeric analogs L-allothreonine and D-allothreonine.

Propofol (1) is converted to the chloroformate derivative (2) by treatment with a phosgene equivalent as illustrated in Scheme 1.

One method for the preparation of compounds of Formula (I) where R¹ is [H₂N(CHR)C(O)]- and R² is OH, i.e., compound (8), is illustrated in Scheme 2. Protected threonine derivative (3) is treated with chloroformate (2) in the presence of a base (e.g. a tertiary amine) to afford intermediate (4), which upon deprotection affords compound (5). Acylation with protected amino acid (6) following to standard peptide coupling protocols yields intermediate (7), which is deprotected to afford the dipeptide propofol carbonate compound (8).

Another method for the preparation of compounds of Formula (I) where R¹ is [H₂N(CHR)C(O)]- and R² is OH, i.e., compound (8), is illustrated in Scheme 3. The protected threonine dipeptide (9) is reacted with chloroformate (2) and further deprotected to afford compound (8).

A compound of Formula (I) where R¹ is hydrogen and R² is OH, i.e. a compound of Formula (III), is prepared by removal of the carboxyl protecting group from compound (5).

4.4 Therapeutic/Prophylactic Uses and Methods of Administration

The compounds of Formulae (I)-(III), as described herein, may be used to treat and/or prevent migraine in patients. The methods comprise administering to a patient a therapeutically effective amount of a compound of Formulae (I)-(III) to treat and/or prevent migraine. In the therapeutic methods herein, a therapeutically effective amount of the compound is administered to a patient suffering from a migraine headache. In the prophylactic methods herein, a therapeutically effective amount of the compound is administered to a patient at risk of developing a migraine.

In some embodiments, the compounds are administered orally to treat and/or prevent migraine. However, in other embodiments, the compounds are administered parenterally (e.g., via inhalation or injection). In some embodiments, the compounds are administered in amounts of between about 10 mg to about 4 g to treat or prevent migraine.

The compounds of Formulae (I)-(III) may also be used as anti-emetics and can be administered to patients at risk of vomiting and/or who are nauseous. For example, the compounds may be administered to patients that are being concurrently treated with various chemotherapy agents and/or surgical procedures, which induce nausea, in order to treat and/or prevent nausea and vomiting. Typically, a therapeutically effective amount of the compound is administered to a patient to treat and/or prevent nausea and vomiting.

In some embodiments, the compounds are administered orally to treat and/or prevent nausea or vomiting. However, in other embodiments, the compounds are administered parenterally (e.g., via inhalation or injection to treat and/or prevent nausea or vomiting. In some embodiments, the compounds are administered in amounts of between about 10 mg to about 4 g to treat and/or prevent nausea or vomiting.

The compounds of Formulae (I)-(III) may also be used as hypnotic agents to induce and/or maintain general anesthesia and/or as a sedative. Typically, a therapeutically effective amount of the compound is administered to a patient to induce hypnosis, anesthesia and/or sedation.

In some embodiments, the compounds are administered intravenously when used as a general anesthetic. In other embodiments, the compounds are administered by inhalation. The compounds may be formulated by methods used to formulate propofol, which are well known in the art. In some embodiments, compounds of Formulae (I)-(III) that are water soluble may be formulated as an injectable aqueous solution, which contains significantly less emulsifiers or solubilizers than used in aqueous formulations of propofol, thereby avoiding discomfort at the site of injection.

In some embodiments, the compounds are administered orally in amounts of about 10 mg to 4 g daily when used as a sedative (e.g., for the treatment of anxiety conditions). However, in other embodiments, the compounds may also be administered by inhalation, intravenously or intramuscularly when used as a sedative.

The compounds of Formulae (I)-(III) may be administered in similar amounts and in the same schedule as described in the art for propofol. In one embodiment, dosage levels of the compounds of Formulae (I)-(III) for producing general anesthesia, maintaining anesthesia and producing a sedative effect are as described in the art for propofol.

The compounds of Formulae (I)-(III) may also be used to inhibit oxidation in biological materials. The methods involve contacting the biological material with an effective amount of the compound. In therapeutic methods herein, a therapeutically effective amount of the compound is administered to a patient suffering from a pathological condition treated by inhibition of oxidation. In prophylactic methods herein, a therapeutically effective amount of the compound is administered to a patient at risk of developing a disease as a result of exposure to oxidative stress. The compounds may find particular use in preventing and/or treating oxidation in disorders of the central nervous system that involve an inflammatory component.

The compounds of Formulae (I)-(III) may be used to treat and/or prevent neurodegenerative conditions of the nervous system, which include, but are not limited to, Friedrich's disease, Parkinson's disease, Alzheimer's disease, Huntington's disease, amyotrophic lateral sclerosis (ALS), multiple sclerosis (MS) and Pick disease. In some embodiments, a therapeutically effective amount of a compound (e.g., between about 10 mg to about 4 g daily) is orally administered to treat and/or prevent chronic neurodegenerative diseases.

The compounds of Formulae (I)-(III) may also be used to treat and/or prevent trauma to the central nervous system such as, for example, skull fracture and its resulting edema, concussion, contusion, brain hemorrhages, shearing lesions, subdural and epidural hematoma, and spinal cord injury (e.g., mechanical injury due to compression or flexion of the spinal cord). In some embodiments, a compound is parenterally administered by intravenous injection or injection directly into the central nervous system (i.e., intrathecally (“IT”) or into the brain) to treat and/or prevent traumatic conditions of the central nervous system. In other embodiments, a therapeutically effective amount of a compound (e.g., between about 25 mg to about 500 mg IV or IM and between about 5 mg to about 100 mg IT) are administered to treat and/or prevent traumatic conditions of the central nervous system.

The compounds of Formulae (I)-(III) may also be used as anti-convulsives to treat and/or prevent seizures (e.g., epileptic seizures). Methods for treating and/or preventing convulsions comprise administering a therapeutically effective amount of a compound to a patient in need of such treatment. In one embodiment, the compounds are administered orally to treat and/or prevent convulsions. In another embodiment, the compounds are parenterally administered to treat and/or prevent convulsions. In still other embodiments, the compounds are administered in amounts of between about 10 mg to about 4 g daily to treat and/or prevent convulsions.

When used to treat and/or prevent the above disease or disorders compounds and/or pharmaceutical compositions of Formulae (I)-(III) may be administered or applied singly, or in combination with other agents. The compounds and/or compositions may also be administered or applied singly, or in combination with other pharmaceutically active agents, including other compounds of Formulae (I)-(III).

Provided herein are methods of treatment and prophylaxis by administering to a patient a therapeutically effective amount of a composition or compound of Formulae (I)-(III). The patient may be an animal, is more preferably, a mammal and even more preferably, a human.

The compounds of Formulae (I)-(III) and/or pharmaceutical compositions thereof are preferably administered orally. The compounds and/or pharmaceutical compositions thereof may also be administered by any other convenient route, for example, by infusion or bolus injection, by absorption through epithelial or mucocutaneous linings (e.g., oral mucosa, rectal and intestinal mucosa, etc.). Administration can be systemic or local. Various delivery systems are known, (e.g., encapsulation in liposomes, microparticles, microcapsules, capsules, etc.) that can be used to administer a compound and/or pharmaceutical composition. Methods of administration include, but are not limited to, intradermal, intramuscular, intraperitoneal, intravenous, subcutaneous, intranasal, epidural, oral, sublingual, intranasal, intracerebral, intravaginal, transdermal, rectally, by inhalation, or topically, particularly to the ears, nose, eyes, or skin.

In specific embodiments, it may be desirable to administer one or more compounds and/or pharmaceutical compositions thereof locally to the area in need of treatment. This may be achieved, for example, and not by way of limitation, by local infusion during surgery, topical application, e.g., in conjunction with a wound dressing after surgery, by injection, by means of a catheter, by means of a suppository, or by means of an implant, said implant being of a porous, non-porous, or gelatinous material, including membranes, such as sialastic membranes or fibers. In one embodiment, administration can be by direct injection at the site (or former site) of cancer or arthritis.

In certain embodiments, it may be desirable to introduce one or more compounds and/or pharmaceutical compositions thereof into the central nervous system by any suitable route, including intraventricular, intrathecal and epidural injection. Intraventricular injection may be facilitated by an intraventricular catheter, for example, attached to a reservoir, such as an Ommaya reservoir.

In some embodiments, the compounds and/or pharmaceutical compositions can be delivered via sustained release systems, preferably oral sustained release systems. In one embodiment, a pump may be used (Langer, supra; Sefton, 1987, CRC Crit Ref Biomed Eng. 14:201; Saudek et al., 1989, N. Engl. J Med. 321:574).

In other embodiments, polymeric materials can be used (see “Medical Applications of Controlled Release,” Langer and Wise (eds.), CRC Pres., Boca Raton, Fla. (1974); “Controlled Drug Bioavailability,” Drug Product Design and Performance, Smolen and Ball (eds.), Wiley, New York (1984); Langer et al., 1983, J Macromol. Sci. Rev. Macromol Chem. 23:61; Levy et al., 1985, Science 228: 190; During et al., 1989, Ann. Neurol. 25.351; Howard et al., 1989, J. Neurosurg. 71:105).

In still other embodiments, polymeric materials are used for oral sustained release delivery. Polymers include, but are not limited to, sodium carboxymethylcellulose, hydroxypropylcellulose, hydroxypropylmethylcellulose and hydroxyethylcellulose. Other cellulose ethers have been described (Alderman, Int. J. Pharm. Tech. & Prod. Mfr. 1984, 5(3) 1-9). Factors affecting drug release are well known to the skilled artisan and have been described in the art (Bamba et al., Int. J. Pharm. 1979, 2, 307).

In still other embodiments, enteric-coated preparations can be used for oral sustained release administration. Preferred coating materials include polymers with a pH-dependent solubility (i.e., pH-controlled release), polymers with a slow or pH-dependent rate of swelling, dissolution or erosion (i.e., time-controlled release), polymers that are degraded by enzymes (i.e., enzyme-controlled release) and polymers that form firm layers that are destroyed by an increase in pressure (i.e., pressure-controlled release).

In still other embodiments, osmotic delivery systems are used for oral sustained release administration (Verma et al., Drug Dev. Ind. Pharm. 2000, 26:695-708). In a preferred embodiment, OROS™ osmotic devices are used for oral sustained release delivery devices (Theeuwes et al., U.S. Pat. No. 3,845,770; Theeuwes et al., U.S. Pat. No. 3,916,899).

For administration by inhalation, a compound may be conveniently delivered to the lung by a number of different devices. For example, a Metered Dose Inhaler (“MDI”) which utilizes canisters that contain a suitable low boiling propellant, e.g., dichlorodifluoromethane, trichlorofluoromethane, dichlorotetrafluoroethane, carbon dioxide or other suitable gas may be used to deliver compounds directly to the lung.

Alternatively, a Dry Powder Inhaler (“DPI)” device may be used to administer a compound to the lung (See, e.g., Raleigh et al., Proc. Amer. Assoc. Cancer Research Annual Meeting 1999, 40, 397). DPI devices typically use a mechanism such as a burst of gas to create a cloud of dry powder inside a container, which may then be inhaled by the patient and are well known in the art and may be purchased from a number of commercial sources. A popular variation is the multiple dose DPI (“MDDPI”) system, which allows for the delivery of more than one therapeutic dose. For example, capsules and cartridges of gelatin for use in an inhaler or insufflator may be formulated containing a powder mix of a compound and a suitable powder base such as lactose or starch for these systems.

Another type of device that may be used to deliver a compound to the lung is a liquid spray device supplied, for example, by Aradigm Corporation, Hayward, Calif. Liquid spray systems use extremely small nozzle holes to aerosolize liquid drug formulations that may then be directly inhaled into the lung.

In one embodiment, a nebulizer device is used to deliver a compound to the lung. Nebulizers create aerosols from liquid drug formulations by using, for example, ultrasonic energy to form fine particles that may be readily inhaled (e.g., Verschoyle et al., British J. Cancer 1999, 80, Suppl. 2, 96; Armer et al., U.S. Pat. No. 5,954,047; van der Linden et al., U.S. Pat. No. 5,950,619; van der Linden et al., U.S. Pat. No. 5,970,974).

In another embodiment, an electrohydrodynamic (“EHD”) aerosol device is used to deliver a compound to the lung. EHD aerosol devices use electrical energy to aerosolize liquid drug solutions or suspensions (see e.g., Noakes et al., U.S. Pat. No. 4,765,539; Coffee, U.S. Pat. No. 4,962,885; Coffee, International Publication No., WO 94/12285; Coffee, International Publication No., WO 94/14543; Coffee, International Publication No., WO 95/26234, Coffee, International Publication No., WO 95/26235, Coffee, International Publication No., WO 95/32807). The electrochemical properties of a compound may be important parameters to optimize when delivering the compound to the lung with an EHD aerosol device, and such optimization is routinely performed by one of skill in the art. EHD aerosol devices may more efficiently deliver drugs to the lung than existing pulmonary delivery technologies. Other methods of intra-pulmonary delivery of a compound will be known to the skilled artisan.

The compounds of Formulae (I)-(III) and/or compositions containing such compounds preferably provide therapeutic or prophylactic levels of propofol upon in vivo administration to a patient. While not wishing to bound by theory, the promoiety or promoieties of the compounds may be cleaved either chemically and/or enzymatically. One or more enzymes present in the stomach, intestinal lumen, intestinal tissue, blood, liver, brain or any other suitable tissue of a mammal may enzymatically cleave the promoiety or promoieties of the administered compounds.

While not wishing to bound by theory, the promoiety or promoieties of the compounds may be cleaved prior to absorption by the gastrointestinal tract (e.g., within the stomach or intestinal lumen) and/or after absorption by the gastrointestinal tract (e.g., in intestinal tissue, blood, liver or other suitable tissue of a mammal). Preferably, propofol remains conjugated to a promoiety during transit across the intestinal mucosal barrier to provide protection from presystemic metabolism. In some embodiments, the compounds are essentially not metabolized to propofol within enterocytes, but are metabolized to the parent drug within the systemic circulation. Cleavage of the promoiety or promoieties of the compounds after absorption by the gastrointestinal tract may allow these prodrugs to be absorbed into the systemic circulation either by active transport, passive diffusion or by a mixture of both active and passive processes. In one embodiment, the compounds are actively absorbed through interaction with the intestinal peptide transporter PEPT1.

Cleavage of the promoiety or promoieties of the compounds of Formulae (I)-(III) after absorption by the gastrointestinal tract, may allow these prodrugs to be absorbed into the systemic circulation from the large intestine. In some embodiments, the compounds and/or pharmaceutical compositions containing compounds of Formulae (I)-(III) are preferably administered as sustained release systems. In other embodiments, the compounds and/or pharmaceutical compositions are delivered by oral sustained release administration. Preferably, in these embodiments, the compounds and/or pharmaceutical compositions are administered twice per day (more preferably, once per day).

4.5 Pharmaceutical Compositions

The present pharmaceutical compositions contain a therapeutically effective amount of one or more compounds of Formulae (I)-(III), preferably, in purified form, together with a suitable amount of a pharmaceutically acceptable vehicle, so as to provide the form for proper administration to a patient. When administered intravenously to a patient, the compounds and pharmaceutically acceptable vehicles are preferably sterile. Water is a preferred vehicle when a compound is administered intravenously. Saline solutions and aqueous dextrose and glycerol solutions can also be employed as liquid vehicles, particularly for injectable solutions. Suitable pharmaceutical vehicles also include excipients such as starch, glucose, lactose, sucrose, gelatin, malt, rice, flour, chalk, silica gel, sodium stearate, glycerol monostearate, talc, sodium chloride, dried skim milk, glycerol, propylene, glycol, water, ethanol and the like. The present compositions, if desired, can also contain minor amounts of wetting or emulsifying agents, or pH buffering agents. In addition, auxiliary, stabilizing, thickening, lubricating and coloring agents may be used.

Pharmaceutical compositions comprising a compound of Formulae (I)-(III) may be manufactured by means of conventional mixing, dissolving, granulating, dragee-making, levigating, emulsifying, encapsulating, entrapping or lyophilizing processes. Pharmaceutical compositions may be formulated in conventional manner using one or more physiologically acceptable carriers, diluents, excipients or auxiliaries, which facilitate processing of compounds into preparations which can be used pharmaceutically. Proper formulation is dependent upon the route of administration chosen.

The present pharmaceutical compositions can take the form of solutions, suspensions, emulsion, tablets, pills, pellets, capsules, capsules containing liquids, powders, sustained-release formulations, suppositories, emulsions, aerosols, sprays, suspensions, or any other form suitable for use. In one embodiment, the pharmaceutically acceptable vehicle is a capsule (see e.g., Grosswald et al., U.S. Pat. No. 5,698,155). Other examples of suitable pharmaceutical vehicles have been described in the art (see Remington's Pharmaceutical Sciences, Philadelphia College of Pharmacy and Science, 19th Edition, 1995). Preferred pharmaceutical compositions are formulated for oral delivery.

Pharmaceutical compositions for oral delivery may be in the form of tablets, lozenges, aqueous or oily suspensions, granules, powders, emulsions, capsules, syrups, or elixirs, for example. Orally administered pharmaceutical compositions may contain one or more optional agents, for example, sweetening agents such as fructose, aspartame or saccharin, flavoring agents such as peppermint, oil of wintergreen, or cherry coloring agents and preserving agents, to provide a pharmaceutically palatable preparation. Moreover, where in tablet or pill form, the pharmaceutical compositions may be coated to delay disintegration and absorption in the gastrointestinal tract, thereby providing a sustained action over an extended period of time. Selectively permeable membranes surrounding an osmotically active driving compound are also suitable for orally administered compounds and pharmaceutical compositions. In these later platforms, fluid from the environment surrounding the capsule is imbibed by the driving compound, which swells to displace the agent or agent composition through an aperture. These delivery platforms can provide an essentially zero order delivery profile as opposed to the spiked profiles of immediate release formulations. A time delay material such as glycerol monostearate or glycerol stearate may also be used. Oral pharmaceutical compositions can include standard vehicles such as mannitol, lactose, starch, magnesium stearate, sodium saccharine, cellulose, magnesium carbonate, etc. Such vehicles are preferably of pharmaceutical grade.

For oral liquid preparations such as, for example, suspensions, elixirs and solutions, suitable carriers, excipients or diluents include water, saline, alkyleneglycols (e.g., propylene glycol), polyalkylene glycols (e.g., polyethylene glycol) oils, alcohols, slightly acidic buffers between pH 4 and pH 6 (e.g., acetate, citrate, ascorbate at between about 5 mM to about 50 mM), etc. Additionally, flavoring agents, preservatives, coloring agents, bile salts, acylcarnitines and the like may be added.

A compound of Formulae (I)-(III) may also be formulated in rectal or vaginal pharmaceutical compositions such as suppositories or retention enemas, e.g., containing conventional suppository bases such as cocoa butter or other glycerides.

In addition to the formulations described previously, a compound of Formulae (I)-(III) may also be formulated as a depot preparation. Such long acting formulations may be administered by implantation (for example subcutaneously or intramuscularly) or by intramuscular injection. Thus, for example, a compound may be formulated with suitable polymeric or hydrophobic materials (for example as an emulsion in an acceptable oil) or ion exchange resins, or as sparingly soluble derivatives, for example, as a sparingly soluble salt.

When a compound of Formulae (I)-(III) is acidic, it may be included in any of the above-described formulations as the free acid, a pharmaceutically acceptable salt, a solvate, hydrate or N-oxide. Pharmaceutically acceptable salts substantially retain the activity of the free acid, may be prepared by reaction with bases and tend to be more soluble in aqueous and other protic solvents than the corresponding free acid form.

Liquid drug formulations suitable for use with nebulizers and liquid spray devices and EHD aerosol devices will typically include a compound with a pharmaceutically acceptable carrier. Preferably, the pharmaceutically acceptable carrier is a liquid such as alcohol, water, polyethylene glycol or a perfluorocarbon. Optionally, another material may be added to alter the aerosol properties of the solution or suspension of the compounds. Preferably, this material is liquid such as an alcohol, glycol, polyglycol or a fatty acid. Other methods of formulating liquid drug solutions or suspension suitable for use in aerosol devices are known to those of skill in the art (e.g., Biesalski, U.S. Pat. No. 5,112,598; Biesalski, U.S. Pat. No. 5,556,611).

4.6 Combination Therapy

In certain embodiments, the compounds of Formulae (I)-(III) can be used in combination therapy with at least one other therapeutic agent. The compound and the other therapeutic agent(s) can act additively or, more preferably, synergistically. In a preferred embodiment, a composition comprising a propofol prodrug compound is administered concurrently with the administration of another therapeutic agent, such as for example, another sedative, hypnotic agent or anesthetic agent (e.g., propofol), which can be part of the same composition as the propofol prodrug compound or a different composition. For example, in the treatment of post-chemotherapy or post-operative nausea and vomiting compounds of Formulae (I)-(III) may be administered together with 5-HT₃ antagonists (e.g., ondansetron, granisetron, dolasetron, palonosetron), corticosteroids (e.g., dexamethasone), dopamine antagonists (e.g., metoclopramide, droperidol, chlorpromazine) or other antiemetic agents (e.g., benzodiazepines such as diazepam or lorazepam; NK-1 antagonists such as aprepitant). In other embodiments, a composition comprising a propofol prodrug compound is administered prior or subsequent to administration of another therapeutic agent, such as, for example, another sedative, hypnotic agent or anesthetic agent, (e.g., propofol).

5. EXAMPLES

The invention is further defined by reference to the following examples, which describe preparation of compounds of Formulae (I)-(III), compositions containing such compounds and assays for using such compounds and compositions. It will be apparent to those skilled in the art that many modifications, both to materials and methods, may be practiced without departing from the scope of the invention.

In the examples below, the following abbreviations have the following meanings. If an abbreviation is not defined, it has its generally accepted meaning.

-   -   Aib=α-aminoisobutyric acid     -   Atm=atmosphere     -   Boc=tert-butyloxycarbonyl     -   Bzl=benzyl     -   Cbz=carbobenzyloxy     -   Dap=L-2,3-diaminopropionic acid     -   DCC=dicyclohexylcarbodiimide     -   DMAP=4-N,N-dimethylaminopyridine     -   DMEM=Dulbecco's minimum eagle medium     -   DMF=N,N-dimethylformamide     -   DMSO=dimethylsulfoxide     -   Fmoc=9-fluorenylmethyloxycarbonyl     -   g=gram     -   h=hour     -   HBSS=Hank's buffered saline solution     -   L=liter     -   LC/MS=liquid chromatography/mass spectroscopy     -   M=molar     -   min minute     -   mL=milliliter     -   mmol=millimoles     -   NHS=N-hydroxysuccinimide     -   PBS=phosphate buffered saline     -   THF=tetrahydrofuran     -   TFA=trifluoroacetic acid     -   TMS=trimethylsilyl     -   μL=microliter     -   μM=micromolar     -   v/v=volume to volume

Example 1 H-Gly-Thr(γ-OC(O)OPropofol)-OH (10) STEP A: 2,6-Bis(isopropyl)phenoxycarbonyl chloride (2)

20% Phosgene in toluene (139 mL, 0.269 mol) was added to a stirring solution of propofol (40 g, 0.225 mmol) in toluene (80.0 mL) under a nitrogen atmosphere at 0° C. N,N-dimethylaniline (34.0 mL, 0.269 mmol) was added dropwise over 15 minutes. The reaction mixture was allowed to warm to room temperature slowly and stirred for 14 h. The reaction mixture was filtered through Celite and the solvent was removed in vacuo. The crude product was carried to next step without further purification. ¹H-NMR (400 MHz, CDCl₃): δ 7.29-7.25 (m, 1H), 7.19-7.17 (m, 2H), 3.04-3.01 (m, 2H), 1.25 (d, J=7.2 Hz, 12H).

STEP B: Boc-Thr(γ-OC(O)OPropofol)-OBn (11)

To an ice cold solution of L-Boc-Thr-OBn (14.1 g, 0.045 mol) in dichloromethane (115 mL) was added propofol chloroformate (2) (14.3 g, 0.059 mmol). To the stirring reaction mixture, diisopropylethylamine (8.74 mL, 0.050 mmol) was added dropwise over 15 minutes followed by a catalytic amount of dimethylaminopyridine (0.558 g, 0.005 mol). The resulting mixture was allowed to warm to room temperature and stirred for 12 h. The mixture was then diluted with ethyl acetate (150 mL) and washed with 10% aqueous citric acid solution (2×75 mL), brine (2×75 mL), dried over MgSO₄, filtered and concentrated in vacuo. The crude oil was purified by chromatography on silica gel (eluting with a gradient of 100% hexane to 20% ethyl acetate in hexane) yielding the product (11) as a white solid (8.25 g, 36% yield). ¹H-NMR (400 MHz, CD₃OD): δ 7.29-7.37 (m, 5H), 7.13-7.22 (m, 3H), 5.36 (m, 1H), 5.11-5.23 (ABq, J=38, 12 Hz, 2H), 4.53 (d, J=3.2 Hz, 1H), 2.98-2.91 (m, 2H), 1.46 (s, 9H), 1.39 (d, J=6.0 Hz, 3H), 1.17 (dd, J=6.4, 3.2 Hz, 12H). MS (ESI) m/z 536.32 (M+Na)⁺.

STEP C: H-Thr(γ-OC(O)OPropofol)-OH (12)

The purified compound (II) from above was dissolved in dichloromethane (80 mL) and treated with trifluoroacetic acid (20 mL). The resulting mixture was stirred at room temperature for 1 h. The solvent was removed in vacuo. To the crude residue was added 10% palladium on carbon (800 mg). After degassing with N₂, the reaction mixture was re-dissolved in a 1:1 (v/v) mixture of ethyl acetate and methanol (250 mL), degassed once more and a stirred under an atmosphere of hydrogen (via balloon). The hydrogenolysis was allowed to proceed over two hours after which the reaction mixture was filtered through Celite and concentrated in vacuo. A portion of the compound was purified by reverse phase LC/MS to afford the title compound (12) as a white solid. ¹H-NMR (400 MHz, CD₃OD): δ 7.14-7.22 (m, 3H), 5.31-5.37 (m, 1H), 3.72 (d, J=4.4 Hz, 1H), 2.97-3.04 (m, 2H), 1.52 (d, J=6.8 Hz, 3H), 1.18 (dd, J=6.8, 4.8 Hz, 12H). MS (ESI) m/z 324.23 (M+H)⁺. The remaining material was used in the next step without further purification.

STEP D: Boc-Gly-Thr(γ-OC(O)OPropofol)-OH (13)

To a solution of Boc-glycine (317 mg, 1.8 mmol) in DMF (6 mL) was added diisopropylethylamine (944 μL, 5.4 mmol) followed by O-(7-azabenzotriazol-1-yl)-N,N,N′,N′-tetramethyluronium hexafluoro-phosphate (671 mg, 1.76 mmol). The resulting mixture was stirred at room temperature for 30 minutes, after which was added a solution of (12) in DMF (2 mL) dropwise and the reaction was allowed to proceed for two hours. The reaction mixture was then diluted with ethyl acetate (40 mL) and was washed with 10% aqueous citric acid solution (2×30 mL), saturated aqueous sodium bicarbonate solution (2×30 mL) and brine (2×30 mL). The organic layer was dried over magnesium sulfate, filtered and then concentrated in vacuo. The crude compound (13) was used without further purification.

STEP E: H-Gly-Thr(γ-OC(O)OPropofol)-OH (10)

The crude compound (13) from above was dissolved in dichloromethane (5 mL) and treated with trifluoroacetic acid (2 mL). The resulting mixture was stirred at room temperature for 1 h. The solvent was removed in vacuo and the crude residue was purified by reverse phase LC/MS to afford the title compound (10) (195 mg, 32% yield). ¹H-NMR (400 MHz, CD₃OD): δ 7.13-7.20 (m, 3H), 5.43-5.49 (m, 1H), 4.58 (d, J=2.8 Hz, 1H), 3.80 (ABq, J=27, 16.4 Hz, 2H), 2.94-3.01 (m, 2H), 1.37 (d, J=6.4 Hz, 3H), 1.17 (t, J=6.8 Hz, 12H). MS (ESI) m/z 381.32 (M+H)⁺.

Example 2 H-Gly-Thr(γ-OC(O)OPropofol)-OH (10) STEP A: Boc-Gly-Thr-O™Bu (14)

To a nitrogen purged, ice cold solution of Boc-glycine (2.16 g, 0.012 mol) in acetonitrile was added dicyclohexylcarbodiimide (2.80 g, 0.013 mol) and N-hydroxy-succinimide (1.49 g, 0.013 mol). The reaction was allowed to stir for 2 h then was filtered and concentrated in vacuo. The resulting oil was re-dissolved in a 1:1 (v/v) solution of acetonitrile and water and treated with sodium bicarbonate (2.23 g, 0.027 mol) and L-threonine α-t-butyl ester. The resulting mixture was stirred at room temperature for 14 h and then diluted with ethyl acetate (100 mL). The organic solution was washed with 10% aqueous citric acid solution (2×50 mL), saturated aqueous sodium bicarbonate solution (2×50 mL) and brine (2×50 mL). The organic layer was dried over magnesium sulfate and then concentrated in vacuo. The crude compound (14) was used without further purification.

STEP B: Boc-Gly-Thr(γ-OC(O)OPropofol)-O^(t)Bu (15)

To a stirring ice cold solution of propofol chloroformate (2) (5.94 g, 0.025 mol) and (14) in dichloromethane (20 mL) was added pyridine (2 mL, 0.025 mol) dropwise over 10 minutes. The resulting mixture was allowed to warm to room temperature and stirred for 12 h. The mixture was diluted with ethyl acetate (75 mL) and washed with 10% aqueous citric acid solution (2×30 mL), dried over MgSO₄, filtered and concentrated in vacuo. The crude product (15) was used in the next step without purification.

STEP C: H-Gly-Thr(γ-OC(O)OPropofol)-OH (10)

The crude compound (15) from above was dissolved in dichloromethane (25 mL) and treated with trifluoroacetic acid (25 mL). The resulting mixture was stirred at room temperature for 3 h. The solvent was removed in vacuo and the crude residue was purified by reverse phase LC/MS to afford the title compound (10) (2.67 g, 57% over three steps).

Example 3 H-Ala-Thr(γ-OC(O)OPropofol)-OH Hydrochloride (16)

Following procedures for the preparation of compound (10) and substituting Boc-L-alanine for Boc-glycine (in STEP D of Example 1 or in STEP A of Example 2), adding 1 equivalent of 1N hydrochloric acid in water, and lyophilizing provided the title compound (16). ¹H-NMR (400 MHz, CD₃OD): δ 7.14-7.22 (m, 3H), 5.47-5.52 (m, 1H), 4.87 (m, 1H), 4.07-4.12 (q, J=14.4 Hz, 1H), 2.91-2.98 (m, 2H), 1.57 (d, J=7.2 Hz, 3H), 1.40 (d, J=6.4 Hz, 3H), 1.17 (dd, J=6.8, 1.6 Hz, 12H). MS (ESI) m/z 395.91 (M+H)⁺.

Example 4 H-Asn-Thr(γ-OC(O)OPropofol)-OH Hydrochloride (17)

Following procedures for the preparation of compound (10) and substituting Boc-L-asparagine(trityl) for Boc-glycine (in STEP D of Example 1 or in STEP A of Example 2), adding 1 equivalent of 1N hydrochloric acid in water, and lyophilizing provided the title compound (17). ¹H-NMR (400 MHz, CD₃OD): δ 7.14-7.22 (m, 3H), 5.47-5.52 (m, 1H), 4.88 (m, 1H), 4.36 (dd, J=10, 3.6 Hz, 1H), 2.91-2.98 (m, 2H), 2.62-2.81 (m, 2H), 1.41 (d, J=6.4 Hz, 3H), 1.17 (dd, J=6.8, 1.6 Hz, 12H). MS (ESI) m/z 438.81 (M+H)⁺.

Example 5 H-Lys-Thr(γ-OC(O)OPropofol)-OH Bis-Hydrochloride (18)

Following procedures for the preparation of compound (10) and substituting Boc-L-lysine(Boc) for Boc-glycine (in STEP D of Example 1 or in STEP A of Example 2), adding 2 equivalent of 1N hydrochloric acid in water, and lyophilizing provided the title compound (18). ¹H-NMR (400 MHz, CD₃OD): δ 7.14-7.23 (m, 3H), 5.48-5.53 (m, 1H), 4.91 (d, J=2.4 Hz, 1H), 4.10 (t, J=6.4 Hz, 1H), 2.91-2.98 (m, 4H), 1.95-2.02 (m, 2H), 1.71-1.78 (m, 2H), 1.55-1.64 (m, 2H), 1.42 (d, J=6.4 Hz, 3H), 1.17 (d, J=6.8 Hz, 12H). MS (ESI) m/z 452.32 (M+H)⁺.

Example 6 H-Ser-Thr(γ-OC(O)OPropofol)-OH Hydrochloride (19)

Following procedures for the preparation of compound (10) and substituting Boc-L-serine(O^(t)Bu) for Boc-glycine (in STEP D of Example 1 or in STEP A of Example 2), adding 1 equivalent of 1N hydrochloric acid in water, and lyophilizing provided the title compound (19). ¹H-NMR (400 MHz, CD₃OD): δ 7.14-7.22 (m, 3H), 5.46-5.51 (m, 1H), 4.87 (m, 1H), 4.11 (dd, J=6.8, 4 Hz, 1H), 4.03 (dd, J=11.6, 4.4 Hz, 1H), 3.87 (dd, J=12, 7.2 Hz, 1H), 2.91-2.98 (m, 2H), 1.41 (d, J=6.4 Hz, 3H), 1.18 (d, J=7.2 Hz, 12H). MS (ESI) m/z 411.81 (M+H)⁺.

Example 7 H-Val-Thr(γ-OC(O)OPropofol)-OH Hydrochloride (20)

Following procedures for the preparation of compound (10) and substituting Boc-L-Valine for Boc-glycine (in STEP D of Example 1 or in STEP A of Example 2), adding 1 equivalent of 1N hydrochloric acid in water, and lyophilizing provided the title compound (20). ¹H-NMR (400 MHz, CD₃OD): δ 7.14-7.22 (m, 3H), 5.47-5.53 (m, 1H), 4.87 (m, 1H), 3.89 (d, J=5.6 Hz, 1H), 2.91-2.98 (m, 2H), 2.26-2.33 (m, 1H), 1.41 (d, J=6.4 Hz, 3H), 1.17 (dd, J=6.8, 1.6 Hz, 12H), 1.08-1.15 (dd, J=20.4, 7.2 Hz, 6H). MS (ESI) m/z 423.86 (M+H)⁺.

Example 8 H-Abu-Thr(γ-OC(O)OPropofol)-OH Hydrochloride (21)

Following procedures for the preparation of compound (1) and substituting Boc-aminobutyric acid for Boc-glycine (in STEP D of Example 1 or in STEP A of Example 2), adding 1 equivalent of 1N hydrochloric acid in water, and lyophilizing provided the title compound (21). ¹H-NMR (400 MHz, CD₃OD): δ 7.14-7.22 (m, 3H), 5.43-5.48 (m, 1H), 4.87 (m, 1H), 2.91-3.03 (m, 4H), 2.53 (m, 2H), 1.94-2.02 (m, 2H), 1.38 (d, J=6.4 Hz, 3H), 1.17 (dd, J=6.8, 3.2 Hz, 12H). MS (ESI) m/z 409.23 (M+H)⁺.

Example 9 H-β-Ala-Thr(γ-OC(O)OPropofol)-OH Hydrochloride (22)

Following procedures for the preparation of compound (1) and substituting Boc-β-alanine for Boc-glycine (in STEP D of Example 1 or in STEP A of Example 2), adding 1 equivalent of 1N hydrochloric acid in water, and lyophilizing provided the title compound (22). ¹H-NMR (400 MHz, CD₃OD): δ 7.14-7.22 (m, 3H), 5.43-5.48 (m, 1H), 4.87 (m, 1H), 3.22 (m, 3H), 2.92-2.99 (m, 2H), 2.77-2.82 (m, 2H), 1.38 (d, J=6.0 Hz, 3H), 1.18 (dd, J=7.2, 2.8 Hz, 12H). MS (ESI) m/z 395.18 (M+H)⁺.

Example 10 H-Arg-Thr(γ-OC(O)OPropofol)-OH Tris-Hydrochloride (23)

Following procedures for the preparation of compound (1) and substituting Boc-L-arginine(Boc)₂ for Boc-glycine (in STEP D of Example 1 or in STEP A of Example 2), adding 3 equivalents of 1N hydrochloric acid in water, and lyophilizing provided the title compound (23). ¹H-NMR (400 MHz, CD₃OD): δ 7.15-7.23 (m, 3H), 5.49-5.54 (m, 1H), 4.91 (d, J=2.8 Hz, 1H), 4.12 (t, J=6.0 Hz, 1H), 3.26 (t, J=7.2 Hz, 2H), 2.91-2.98 (m, 2H), 1.98-2.04 (m, 2H), 1.75-1.88 (m, 2H), 1.42 (d, J=6.0 Hz, 3H), 1.18 (d, J=7.2 Hz, 12H). MS (ESI) m/z 480.31 (M+H)⁺.

Example 11 H-Dap-Thr(γ-OC(O)OPropofol)-OH Bis-Hydrochloride (24)

Following procedures for the preparation of compound (1) and substituting Boc-L-diaminopropionic(Boc) acid for Boc-glycine (in STEP D of Example 1 or in STEP A of Example 2), adding 2 equivalent of 1N hydrochloric acid in water, and lyophilizing provided the title compound (24). ¹H-NMR (400 MHz, CD₃OD): δ 7.15-7.23 (m, 3H), 5.52-5.57 (m, 1H), 4.98 (d, J=2.4 Hz, 1H), 4.48 (t, J=5.2 Hz, 1H), 3.54 (m, 2H), 2.90-2.97 (m, 2H), 1.46 (d, J=6.4 Hz, 3H), 1.18 (dd, J=7.2, 1.6 Hz 12H). MS (ESI) m/z 410.29 (M+H)⁺.

Example 12 H-His-Thr(γ-OC(O)OPropofol)-OH Bis-Hydrochloride (25)

Following procedures for the preparation of compound (1) and substituting Boc-L-histidine(N-Bn) for Boc-glycine (in STEP D of Example 1 or in STEP A of Example 2), and an additional step (in STEP E of Example 1 or in STEP C of Example 2) of hydrogenolysis prior to treatment with trifluoroacetic acid afforded the title compound (25). To the crude residue (untreated with trifluoroacetic acid) was added 10% palladium on carbon. After degassing with N₂, the reaction mixture was re-dissolved in a 1:1 (v/v) mixture of ethyl acetate and methanol, degassed once more and a stirred under an atmosphere of hydrogen (via balloon). The hydrogenolysis was allowed to proceed over two hours after which the reaction mixture was filtered through Celite and concentrated in vacuo. After treatment with trifluoroacetic acid, purification (as described in STEP E of Example 1 or in STEP C of Example 2), addition of 2 equivalents of 1N hydrochloric acid in water, and lyophilization, the title compound (25) was afforded. ¹H-NMR (400 MHz, CD₃OD): δ 8.87 (s, 1H), 7.55 (s, 1H), 7.14-7.22 (m, 3H), 5.48-5.53 (m, 1H), 4.93 (d, J=2.4 Hz, 1H), 4.43 (t, J=6.4 Hz, 1H), 3.45 (m, 2H), 2.90-2.97 (m, 2H), 1.43 (d, J=6.0 Hz, 3H), 1.17 (dd, J=6.8, 2.8 Hz, 12H). MS (ESI) m/z 461.31 (M+H)⁺.

Example 13 H-Leu-Thr(γ-OC(O)OPropofol)-OH Hydrochloride (26)

Following procedures for the preparation of compound (1) and substituting Boc-L-leucine for Boc-glycine (in STEP D of Example 1 or in STEP A of Example 2), adding 1 equivalent of 1N hydrochloric acid in water, and lyophilizing provided the title compound (26). ¹H-NMR (400 MHz, CD₃OD): δ 7.14-7.22 (m, 3H), 5.47-5.53 (m, 1H), 4.87 (m, 1H), 4.09 (dd, J=8.8, 4.8 Hz, 1H), 2.92-2.99 (m, 2H), 1.70-1.86 (m, 3H), 1.42 (d, J=6.8 Hz, 3H), 1.17 (d, J=7.2 Hz, 12H), 1.03 (t, J=6 Hz, 6H). MS (ESI) m/z 437.38 (M+H)⁺.

Example 14 H-Met-Thr(γ-OC(O)OPropofol)-OH Hydrochloride (27)

Following procedures for the preparation of compound (1) and substituting Boc-L-methionine for Boc-glycine (in STEP D of Example 1 or in STEP A of Example 2), adding 1 equivalent of 1N hydrochloric acid in water, and lyophilizing provided the title compound (27). ¹H-NMR (400 MHz, CD₃OD): δ 7.14-7.22 (m, 3H), 5.48-5.54 (m, 1H), 4.87 (d, J=2.4 Hz, 1H), 4.15 (t, J=5.6 Hz, 1H), 2.92-2.99 (m, 2H), 2.62-2.74 (m, 2H), 2.18-2.24 (m, 2H), 2.15 (s, 3H), 1.42 (d, J=6.8 Hz, 3H), 1.18 (d, J=7.2 Hz, 12H). MS (ESI) m/z 455.28 (M+H)⁺.

Example 15 H-Orn-Thr(γ-OC(O)OPropofol)-OH Bis-Hydrochloride (28)

Following procedures for the preparation of compound (1) and substituting Boc-L-ornithine(Boc) for Boc-glycine (in STEP D of Example 1 or in STEP A of Example 2), adding 2 equivalent of 1N hydrochloric acid in water, and lyophilizing provided the title compound (28). ¹H-NMR (400 MHz, CD₃OD): δ 7.15-7.23 (m, 3H), 5.49-5.54 (m, 1H), 4.92 (d, J=2.0 Hz, 1H), 4.15 (t, J=6.0 Hz, 1H), 2.76-3.03 (m, 4H), 1.99-2.05 (m, 2H), 1.80-1.95 (m, 2H), 1.43 (d, J=6.4 Hz, 3H), 1.18 (d, J=6.8 Hz, 12H). MS (ESI) m/z 438.34 (M+H)⁺.

Example 16 H-Pro-Thr(γ-OC(O)OPropofol)-OH Hydrochloride (29)

Following procedures for the preparation of compound (1) and substituting Boc-L-proline for Boc-glycine (in STEP D of Example 1 or in STEP A of Example 2), adding 1 equivalent of 1N hydrochloric acid in water, and lyophilizing provided the title compound (29). ¹H-NMR (400 MHz, CD₃OD): δ 7.15-7.23 (m, 3H), 5.47-5.53 (m, 1H), 4.86 (d, J=2.4 Hz, 1H), 4.43 (t, J=6.4 Hz, 1H), 3.31-3.48 (m, 2H), 2.90-2.98 (m, 2H), 2.47-2.54 (m, 1H), 2.16-2.23 (m, 1H), 2.02-2.10 (m, 2H), 1.43 (d, J=6.4 Hz, 3H), 1.18 (d, J=6.8 Hz, 12H). MS (ESI) m/z 421.33 (M+H)⁺.

Example 17 H-D-Asn-Thr(γ-OC(O)OPropofol)-OH (30)

Following procedures for the preparation of compound (1) and substituting Boc-D-asparagine(trityl) for Boc-glycine (in STEP D of Example 1 or in STEP A of Example 2) provided the title compound (30). ¹H-NMR (400 MHz, CD₃OD): δ 7.12-7.20 (m, 3H), 5.47-5.52 (m, 1H), 4.52 (d, J=2.8 Hz, 1H), 4.31 (dd, J=8, 4.8 Hz, 1H), 2.89-3.01 (m, 3H), 2.73-2.79 (m, 1H), 1.34 (d, J=6.0 Hz, 3H), 1.17 (t, J=7.2 Hz, 12H). MS (ESI) m/z 438.33 (M+H)⁺.

Example 18 H-D-Lys-Thr(γ-OC(O)OPropofol)-OH Bis-Hydrochloride (31)

Following procedures for the preparation of compound (1) and substituting Boc-D-lysine(Boc) for Boc-glycine (in STEP D of Example 1 or in STEP A of Example 2), adding 2 equivalent of 2N hydrochloric acid in water, and lyophilizing provided the title compound (31). ¹H-NMR (400 MHz, CD₃OD): δ 7.15-7.23 (m, 3H), 5.48-5.53 (m, 1H), 4.88 (m, 1H), 4.11 (t, J=6.4 Hz, 1H), 2.92-2.99 (m, 4H), 1.90-2.06 (m, 2H), 1.71-1.79 (m, 2H), 1.52-1.60 (m, 2H), 1.39 (d, J=6.0 Hz, 3H), 1.18 (dd, J=6.8, 3.6 Hz, 12H). MS (ESI) m/z 452.41 (M+H)⁺.

Example 19 H-D-Ser-Thr(γ-OC(O)OPropofol-OH Hydrochloride (32)

Following procedures for the preparation of compound (1) and substituting Boc-D-serine(O^(t)Bu) for Boc-glycine (in STEP D of Example 1 or in STEP A of Example 2), adding 1 equivalent of 1N hydrochloric acid in water, and lyophilizing provided the title compound (32). ¹H-NMR (400 MHz, CD₃OD): δ 7.14-7.22 (m, 3H), 5.46-5.50 (m, 1H), 4.92 (m, 1H), 4.12 (dd, J=9.2, 5.6 Hz, 1H), 3.99-4.06 (m, 1H), 3.85-3.93 (m, 1H), 2.90-2.99 (m, 2H), 1.37-1.42 (dd, J=12, 7.2 Hz, 3H), 1.18 (m, 12H). MS (ESI) m/z 411.35 (M+H)⁺.

Example 20 H-Asn-D-Thr(γ-OC(O)OPropofol)-OH (33)

Following procedures for the preparation of compound (1) and first substituting Boc-D-threonine-OBn for Boc-L-threonine-OBn in STEP B of Example 1 or D-threonine α-t-butyl ester in STEP A of Example 2 and then substituting Boc-asparagine(trityl) for Boc-glycine (in STEP D of Example 1 or in STEP A of Example 2) provided the title compound (33). ¹H-NMR (400 MHz, CD₃OD): δ 7.12-7.25 (m, 3H), 5.47-5.51 (m, 1H), 4.90 (m, 1H), 4.31 (dd, J=9.2, 4.8 Hz, 1H), 2.82-3.01 (m, 4H), 1.38 (d, J=6.4 Hz, 3H), 1.18 (dd, J=6.8, 3.2 Hz, 12H). MS (ESI) m/z 438.33 (M+H)⁺.

Example 21 H-Leu-D-Thr(γ-OC(O)OPropofol)-OH (34)

Following procedures for the preparation of compound (1) and first substituting Boc-D-threonine-OBn for Boc-L-threonine-OBn in STEP B of Example 1 or D-threonine α-t-butyl ester in STEP A of Example 2 and then substituting Boc-leucine for Boc-glycine (in STEP D of Example 1 or in STEP A of Example 2) provided the title compound (34). ¹H-NMR (400 MHz, CD₃OD): δ 7.13-7.21 (m, 3H), 5.48-5.51 (m, 1H), 4.60 (d, J=2.4 Hz, 1H), 4.06 (t, J=7.6 Hz, 1H), 2.95-3.02 (m, 2H), 1.64-1.84 (m, 3H), 1.18 (d, J=6.0 Hz, 12H), 1.02-1.07 (dd, J=12.4, 6.4 Hz, 6H). MS (ESI) m/z 437.38 (M+H)⁺.

Example 22 H-Ser-D-Thr(γ-OC(O)OPropofol)-OH (35)

Following procedures for the preparation of compound (1) and first substituting Boc-D-threonine-OBn for Boc-L-threonine-OBn in STEP B of Example 1 or D-threonine α-t-butyl ester in STEP A of Example 2 and then substituting Boc-leucine for Boc-glycine (in STEP D of Example 1 or in STEP A of Example 2) provided the title compound (35). ¹H-NMR (400 MHz, CD₃OD): δ 7.13-7.21 (m, 3H), 5.42-5.48 (m, 1H), 4.60 (d, J=2.8 Hz, 1H), 4.10 (dd, J=7.2, 4.8 Hz, 1H), 3.98 (dd, J=11.2, 4.4 Hz, 1H), 3.86 (dd, J=11.2, 6.8 Hz, 1H), 2.94-3.02 (m, 2H), 1.41 (d, J=6.8 Hz, 3H), 1.18 (d, J=6.8 Hz, 12H). MS (ESI) m/z 411.38 (M+H)⁺.

Example 23 In Vitro Compound Transport Assays Analysis of Electrogenic Transport in PEPT1-Expressing Xenopus Oocytes

Transport-induced currents were also measured in Xenopus oocytes transfected with rat and human PEPT1 as described in PCT Application WO01/20331. Briefly:

RNA preparation: Rat and human PEPT1 transporter cDNAs were subcloned into a modified pGEM plasmid that contains 5′ and 3′ untranslated sequences from the Xenopus β-actin gene. These sequences increase RNA stability and protein expression. Plasmid cDNA was linearized and used as template for in vitro transcription (Epicentre Technologies transcription kit, 4:1 methylated:non-methylated GTP).

Xenopus oocyte isolation. Xenopus laevis frogs were anesthetized by immersion in Tricaine (1.5 g/mL in deionized water) for 15 min. Oocytes were removed and digested in frog ringer solution (90 mM NaCl, 2 mM KCl, 1 mM MgCl₂, 10 mM NaHEPES, pH 7.45, no CaCl₂) with 1 mg/mL collagenase (Worthington Type 3) for 80-100 min with shaking. The oocytes were washed 6 times, and the buffer changed to frog ringer solution containing CaCl₂ (1.8 mM). Remaining follicle cells were removed if necessary. Cells were incubated at 16° C., and each oocyte injected with 10-20 μg RNA in 45 μL solution.

Electrophysiology measurements. Transport currents were measured 2-14 days after injection, using a standard two-electrode electrophysiology set-up (Geneclamp 500 amplifier, Digidata 1320/PCLAMP software and ADInstruments hardware and software were used for signal acquisition). Electrodes (2-4 mΩ) were microfabricated using a Sutter Instrument puller and filled with 3M KCl. The bath was directly grounded (transporter currents were less than 0.3 μA). Bath flow was controlled by an automated perfusion system (ALA Scientific Instruments, solenoid valves).

For transporter pharmacology, oocytes were clamped at −60 to −90 mV, and continuous current measurements acquired using PowerLab Software and an ADInstruments digitizer. Current signals were lowpass filtered at 20 Hz and acquired at 4-8 Hz. All bath and drug-containing solutions were frog ringers solution containing CaCl₂. Drugs were applied for 10-30 seconds until the induced current reached a new steady-state level, followed by a control solution until baseline currents returned to levels that preceded drug application. The difference current (baseline subtracted from peak current during drug application) reflected the net movement of charge resulting from electrogenic transport and was directly proportional to transport rate. Recordings were made from a single oocyte for up to 60 min, enabling 30-40 separate compounds to be tested per oocyte. Compound-induced currents were saturable and gave half-maximal values at substrate concentrations comparable to radiolabel competition experiments. To compare results between oocytes expressing different levels of transport activity, a saturating concentration of glycyl-sarcosine (1 mM) was used as a common reference to normalize results from test compounds. Using this normalization procedure I_(max) (i.e. maximal induced current) for different compounds tested on different oocytes could be compared.

Each of the compounds (10), (16)-(20), (24)-(28) and (32) elicited PEPT-specific currents significantly above background (at least 2% of I_(max) for Gly-Sar) when tested at 3 mM on oocytes expressing PEPT1, confirming that these compounds serve as substrates for this transporter.

Example 24 Standard Methods for Determination of Enzymatic Cleavage of Prodrugs in Vitro

The stability of propofol prodrugs were evaluated in one or more in vitro systems using a variety of tissue preparations following methods known in the art. Tissues were obtained from commercial sources (e.g., Pel-Freez Biologicals, Rogers, Ark., or GenTest Corporation, Woburn, Mass.). Experimental conditions used for the in vitro studies are described in Table 1 below. Each preparation was incubated with test compound at 37° C. for one hour. Aliquots (50 μL) were removed at 0, 30, and 60 min and quenched with 0.1% trifluoroacetic acid in acetonitrile. Samples were then centrifuged and analyzed by LC/MS/MS (see Example 134 below for method details). Stability of drug conjugates towards specific enzymes (e.g., peptidases, etc.) were also assessed in vitro by incubation with the purified enzyme.

Pancreatin Stability: Stability studies were conducted by incubating conjugate (5 μM) with 1% (w/v) pancreatin (Sigma, P-1625, from porcine pancreas) in 0.025 M Tris buffer containing 0.5 M NaCl (pH 7.5) at 37° C. for 60 min. The reaction was stopped by addition of 2 volumes of methanol. After centrifugation at 14,000 rpm for 10 min, the supernatant was removed and analyzed by LC/MS/MS.

Caco-2 Homogenate S9 Stability: Caco-2 cells were grown for 21 days prior to harvesting. Culture medium was removed and cell monolayers were rinsed and scraped off into ice-cold 10 mM sodium phosphate/0.15 M potassium chloride, pH 7.4. Cells were lysed by sonication at 4° C. using a probe sonicator. Lysed cells were then transferred into 1.5 mL centrifuge vials and centrifuged at 9000 g for 20 min at 4° C. The resulting supernatant (Caco-2 cell homogenate S9 fraction) was aliquoted into 0.5 mL vials and stored at −80° C. until used.

For stability studies, prodrug (5 μM) was incubated in Caco-2 homogenate S9 fraction (0.5 mg protein per mL) for 60 min at 37° C. Concentrations of intact prodrug and released propofol were determined at zero time and 60 minutes using LC/MS/MS.

Preferred conjugates demonstrate at least 1% cleavage to produce the free drug or an active metabolite thereof within a 60 minute period, as summarized in Table 2.

TABLE 1 Standard Conditions for Conjugate In Vitro Metabolism Studies Substrate Preparation Concentration Cofactors Human Plasma 2.0 μM None Human Liver S9 2.0 μM NADPH (0.5 mg/mL) Caco-2 5.0 μM None Homogenate Pancreatin 5.0 μM None *NADPH generating system, e.g., 1.3 mM NADP+, 3.3 mM glucose-6-phosphate, 0.4 U/mL glucose-6-phosphate dehydrogenase, 3.3 mM magnesium chloride and 0.95 mg/mL potassium phosphate, pH 7.4.

TABLE 2 % of Propofol Released from Propofol Prodrugs after 60 min. in Various Tissue Preparations (10) (16) (18) (23) (24) (25) (26) Human Plasma 2 4 12 25 0 0 0 Human Liver S9 2 22 32 93 1 8 37 (0.5 mg/mL) Caco-2 S9 30 33 33 100 21 52 93 Pancreatin 43 25 1 4 0 0 30 (27) (28) Human Plasma 0 2 Human Liver S9 0 11 (0.5 mg/mL) Caco-2 S9 20 54 Pancreatin 0 0

Example 25 Uptake of Propofol Following Oral Administration of Prodrugs to Monkeys Step A Administration Protocol

Test compounds were administered by oral gavage or as an intravenous bolus injection to groups of two to four adult male Cynomologous (Macaca fascicularis) monkeys (weight approx 5 kg) as solutions in water or PEG400 at a dose of 25 mg-equivalents of propofol per kg body weight. Animals were fasted overnight before the study and for 4 hours post-dosing. Blood samples (1.0 mL) were obtained via the femoral vein at intervals over 24 hours after oral dosing. Blood was quenched immediately using acetonitrile with 1% formic acid and then was frozen at −80° C. until analyzed. Test compounds are administered in the monkeys with a minimum of 72 hour wash out period between dosing sessions.

Step B LC/MS/MS Analysis

Concentrations of propofol in plasma were determined using an API 4000 LC/MS/MS instrument equipped with an Agilent 1100 binary pump and an Agilent autosampler. The column was a Phenomenex Hydro-RP 4.6*50 mm column operating at room temperature. The mobile phases were 2 mM aqueous ammonium acetate (A) and 95% acetonitrile with 5 mM ammonium acetate (B). The gradient condition was: 5% B for 1 min, increasing to 90% B in 2.5 min and maintained for 2 min. 20 μL of sample was injected. A Turbo-IonSpray source was used, and propofol was detected in negative ion mode in Q1 at m/z=177. Prodrugs were detected in positive ion mode, using MRM transitions of 323.97/101.91 for (12), 452.11/84.05 for (18), 411.04/189.05 for (19), 480.05/70.24 for (23), 409.99/159.00 for (24), as well as prodrugs (10) and (27). The peaks were integrated using Analyst 1.2 quantitation software.

Oral bioavailability (F) of the prodrugs as propofol in monkeys were determined by comparison of the areas under the propofol concentration versus time curves (AUC) following oral administration of the prodrugs with the AUC measured following intravenous administration of propofol itself on a dose-normalized basis. Each of the above compounds (prodrugs (10), (12), (18), (19), (23), (24), and (27)) had oral bioavailabilities as propofol >10%, illustrating that actively transported prodrugs can afford significant enhancements in oral bioavailability of propofol.

Example 26 Uptake of Propofol Following Oral or Intravenous Administration of Prodrugs to Rats Step 1 Administration Protocol

Propofol or propofol prodrug was administered as an intravenous bolus injection or by oral gavage to groups of four to six adult male Sprague-Dawley rats (weight approx 250 g). Animals were conscious at the time of the experiment. Propofol or propofol prodrug was orally administered as an aqueous solution at a dose equivalent to 25 mg of propofol per kg body weight. When administered intravenously, propofol or propofol prodrug was administered as a solution in Diprivan® (Astra-Zeneca) at a dose equivalent to 15 mg of propofol per kg body weight. Animals were fasted overnight before the study and for 4 hours post-dosing. Blood samples (0.3 mL) were obtained via a jugular vein cannula at intervals over 8 hours after oral dosing. Blood was quenched immediately using acetonitrile with 1% formic acid and then was frozen at −80° C. until analyzed.

Step 2 Sample Preparation for Absorbed Drug

1. In blank 1.5 mL tubes, 300 μL of 0.1% formic acid in acetonitrile was added.

2. Rat blood (300 μL) was collected at different times into EDTA tubes and vortexed to mix. A fixed volume of blood (100 μL) was immediately added into the Eppendorf tube and vortexed to mix.

3. Ten microliters of a propofol standard stock solution (0.04, 0.2, 1, 5, 25, 100 μg/mL) was added to 90 μL of blank rat blood quenched with 300 μL of 0.1% formic acid in acetonitrile. Then, 20 μL of p-chlorophenylalanine was added to each tube to make the to make up a final calibration standard (0.004, 0.02, 0.1, 0.5, 2.5, 10 μg/mL).

4. Samples were vortexed and centrifuged at 14,000 rpm for 10 min.

5. Supernatant was analyzed by LC/MS/MS.

Step 3 LC/MS/MS Analysis

An API 4000 LC/MS/MS spectrometer equipped with Agilent 1100 binary pumps and a CTC HTS-PAL autosampler were used in the analysis. A Phenomenex Synergihydro-RP 4.6×30 mm column was used during the analysis. The mobile phase for propofol analysis was (A) 2 mM ammonium acetate, and (B) 5 mM ammonium acetate in 95% acetonitrile. The mobile phase for the analysis of propofol prodrugs was (A) 0.1% formic acid, and (B) 0.1% formic acid in acetonitrile. The gradient condition was: 10% B for 0.5 min, then to 95% B in 2.5 min, then maintained at 95% B for 1.5 min. The mobile phase was returned to 10% B for 2 min. An ACPI source was used on the API 4000. The analysis was done in negative ion mode for propofol and positive ion mode for propofol prodrugs. The MRM transition for each analyte was optimized using standard solutions. 5 μL of the samples were injected. Non-compartmental analysis was performed using WinNonlin (v.3.1 Professional Version, Pharsight Corporation, Mountain View, Calif.) on individual animal profiles. Summary statistics on major parameter estimates was performed for C_(max) (peak observed concentration following dosing), T_(max) (time to maximum concentration is the time at which the peak concentration was observed), AUC_((0-t)) (area under the serum concentration-time curve from time zero to last collection time, estimated using the log-linear trapezoidal method), AUC_((0-∞)), (area under the serum concentration time curve from time zero to infinity, estimated using the log-linear trapezoidal method to the last collection time with extrapolation to infinity), and t_(1/2,z) (terminal half-life).

The oral bioavailability (F) of propofol was determined by comparing the area under the propofol concentration vs time curve (AUC) following oral administration of propofol with the AUC of the propofol concentration vs time curve following intravenous administration of propofol on a dose normalized basis. Using this measurement technique, the oral bioavailability of propofol was found to be very low, as expected (F=0.23%).

Oral bioavailability (F) of propofol, resulting from oral administration of the propofol prodrugs (10) and (27) in rats was determined by comparing the area under the propofol concentration vs time curve (AUC) following oral administration of the propofol prodrugs (10) and (27), and with the AUC measured following intravenous administration of an equimolar dose of propofol itself. Prodrugs (10) and (27) provided greater than 10% absolute oral bioavailability of propofol, i.e., compared to the bioavailability of propofol following intravenous administration of an equimolar dose of propofol itself. Thus, prodrugs (10) and (27) provided at least about 40 times higher oral bioavailability of propofol compared to the oral bioavailability of propofol itself. The result illustrates that prodrugs of the present disclosure can afford significant enhancements in oral bioavailability of propofol in rats.

Finally, it should be noted that there are alternative ways of implementing the present invention. Accordingly, the present embodiments are to be considered as illustrative and not restrictive, and the invention is not to be limited to the details given herein, but may be modified within the scope and equivalents of the claim(s) issuing herefrom. All publications and patents cited herein are incorporated by reference. 

1-12. (canceled)
 13. A compound of Formula (I) is provided:

or a pharmaceutically acceptable salt, hydrate, solvate or N-oxide thereof, wherein: R¹ is selected from the group consisting of hydrogen, (R⁵NH(CHR⁴)_(p)C(O))—, R⁶—, R⁶C(O)—, and R⁶OC(O)—; R² is —OR⁷; p is 1 or 2; each R⁴ is independently selected from the group consisting of hydrogen, alkyl, substituted alkyl, alkoxy, substituted alkoxy, acyl, substituted acyl, alkoxycarbonyl, substituted alkoxycarbonyl, aryl, substituted aryl, arylalkyl, substituted arylalkyl, carbamoyl, substituted carbamoyl, cycloalkyl, substituted cycloalkyl, cycloheteroalkyl, substituted cycloheteroalkyl, heteroalkyl, substituted heteroalkyl, heteroaryl, substituted heteroaryl, heteroarylalkyl, and substituted heteroarylalkyl; or when R⁴ and R⁵ are attached to adjacent atoms then R⁴ and R⁵ together with the atoms to which they are bonded form a cycloheteroalkyl or substituted cycloheteroalkyl ring; R⁵ is selected from the group consisting of hydrogen, R⁶—, R⁶C(O)—, and R⁶OC(O)—; R⁶ is selected from the group consisting of alkyl, substituted alkyl, aryl, substituted aryl, arylalkyl, substituted arylalkyl, cycloalkyl, substituted cycloalkyl, cycloheteroalkyl, heteroaryl, substituted heteroaryl, and heteroarylalkyl; and R⁷ is selected from the group consisting of hydrogen, alkyl, substituted alkyl, aryl, substituted aryl, arylalkyl, substituted arylalkyl, cycloalkyl, substituted cycloalkyl, cycloheteroalkyl, heteroaryl, substituted heteroaryl, and heteroarylalkyl.
 14. The compound of claim 13, wherein: R¹ is [R⁵NH(CHR⁴)_(p)C(O)]—; p is 1; R⁵ is hydrogen; and R⁴ is selected from the group consisting of hydrogen, alkanyl, substituted alkanyl, aryl, substituted aryl, arylalkanyl, substituted arylalkanyl, cycloalkanyl, heteroarylalkanyl, and substituted heteroarylalkanyl.
 15. The compound of claim 13, wherein: R¹ is [R⁵NH(CHR⁴)_(p)C(O)]—; p is 1; R⁵ is hydrogen; and R⁴ is selected from the group consisting of hydrogen, methyl, isopropyl, isobutyl, sec-butyl, t-butyl, cyclopentyl, cyclohexyl, —CH₂OH, —CH(OH)CH₃, —CH₂CO₂H, —CH₂CH₂CO₂H, —CH₂CONH₂, —CH₂CH₂CONH₂, —CH₂CH₂SCH₃, —CH₂SH, —CH₂(CH₂)₃NH₂, —CH₂CH₂CH₂NHC(NH)NH₂, phenyl, benzyl, 4-hydroxybenzyl, 4-imidazolylmethyl, and 3-indolylmethyl.
 16. The compound of claim 13, wherein R⁷ is selected from the group consisting of hydrogen, C₁₋₄ alkyl, phenyl, substituted phenyl, benzyl, and substituted benzyl.
 17. The compound of claim 15, wherein R⁷ is selected from the group consisting of hydrogen, C₁₋₄ alkyl, phenyl, substituted phenyl, benzyl, and substituted benzyl.
 18. The compound of claim 15, wherein the α-carbon of the N-terminal amino acid residue is of the L-configuration.
 19. The compound of claim 15, wherein the α-carbon of the N-terminal amino acid residue is of the D-configuration.
 20. The compound of claim 15, wherein the α-carbon of the C-terminal amino acid residue is of the L-configuration.
 21. The compound of claim 15, wherein the α-carbon of the C-terminal amino acid residue is of the D-configuration.
 22. A pharmaceutical composition comprising a therapeutically effective amount of a compound according to claim 13 and a pharmaceutically acceptable vehicle.
 23. The composition of claim 22, for treatment of nausea and vomiting comprising a 5-HT₃ antagonist, a corticosteroid, or a combination thereof.
 24. The composition of claim 23, wherein the 5-HT₃ antagonist is selected from the group consisting of ondansetron, granisetron, dolasetron, and palonosetron; and the corticosteroid is dexamethasone.
 25. A pharmaceutical composition comprising a therapeutically effective amount of a compound according to claim 17 and a pharmaceutically acceptable vehicle.
 26. The composition of claim 25, for treatment of nausea and vomiting comprising a 5-HT₃ antagonist, a corticosteroid, or a combination thereof.
 27. The composition of claim 26, wherein the 5-HT₃ antagonist is selected from the group consisting of ondansetron, granisetron, dolasetron, and palonosetron; and the corticosteroid is dexamethasone.
 28. A method for treating migraine, nausea, vomiting, anxiety, seizures, convulsions, trauma of the central nervous system, and neurodegenerative conditions selected from the group consisting of Friedrich's disease, Parkinson's disease, Alzheimer's disease, Huntington's disease, amyotrophic lateral sclerosis, multiple sclerosis, and Pick disease in a patient, comprising administering to a patient in need of such treatment a therapeutically effective amount of a pharmaceutical composition according to claim
 22. 29. A method for treating migraine, nausea, vomiting, anxiety, seizures, convulsions, trauma of the central nervous system, and neurodegenerative conditions g selected from the group consisting of Friedrich's disease, Parkinson's disease, Alzheimer's disease, Huntington's disease, amyotrophic lateral sclerosis, multiple sclerosis, and Pick disease in a patient, comprising administering to a patient in need of such treatment a therapeutically effective amount of a pharmaceutical composition according to claim
 25. 30. A method for treating migraine in a patient comprising administering to a patient in need of such treatment a therapeutically effective amount of a pharmaceutical composition according to claim
 22. 31. A method for treating migraine in a patient comprising administering to a patient in need of such treatment a therapeutically effective amount of a pharmaceutical composition according to claim
 25. 32. A method for treating nausea and vomiting in a patient comprising administering to a patient in need of such treatment a therapeutically effective amount of a pharmaceutical composition according to claim
 22. 33. The composition of claim 32, comprising a 5-HT₃ antagonist, a corticosteroid, or a combination thereof.
 34. The composition of claim 33, wherein the 5-HT₃ antagonist is selected from the group consisting of ondansetron, granisetron, dolasetron, and palonosetron; and the corticosteroid is dexamethasone.
 35. A method for treating nausea and vomiting in a patient comprising administering to a patient in need of such treatment a therapeutically effective amount of a pharmaceutical composition according to claim
 25. 36. The composition of claim 35, comprising a 5-HT₃ antagonist, a corticosteroid, or a combination thereof.
 37. The composition of claim 36, wherein the 5-HT₃ antagonist is selected from the group consisting of ondansetron, granisetron, dolasetron, and palonosetron; and the corticosteroid is dexamethasone. 